| NPI | 1750190195 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRADLEY JAMES MCCONNELL Licensed Psychologist/Owner 833-872-7792 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TF0200X Psychologist Forensic |
| Enumeration Date | 2024-12-31 |
| Last Update Date | 2024-12-31 |