| NPI | 1760935894 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SONYA LALISSE LOTT Psychologist 267-825-0467 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: PA PS006143L) |
| Enumeration Date | 2016-07-25 |
| Last Update Date | 2016-07-25 |