| NPI | 1740516293 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONNA DOOLEY CFO 800-370-3651 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist |
| 1041C0700X Social Worker, Clinical | |
| 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry | |
| 363A00000X Physician Assistant | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| 364SP0809X Clinical Nurse Specialist, Psych/Mental Health, Adult | |
| Enumeration Date | 2009-10-19 |
| Last Update Date | 2016-08-30 |