| NPI | 1770064289 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL H GROENEWAL Partner 551-206-2479 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YM0800X Counselor, Mental Health | |
| 103TC0700X Psychologist, Clinical (Licence: NJ 35SI00494500) | |
| 1041C0700X Social Worker, Clinical (Licence: NJ 44SC05287100) | |
| Enumeration Date | 2018-08-23 |
| Last Update Date | 2021-07-20 |