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 |