| NPI | 1730928755 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YICHEN WANG Owner 339-205-9684 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YM0800X Counselor, Mental Health | |
| 103TB0200X Psychologist, Cognitive & Behavioral | |
| 103TH0100X Psychologist, Health Service | |
| Enumeration Date | 2024-05-20 |
| Last Update Date | 2024-05-20 |