| NPI | 1780994343 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNY ZAYAS Account Manager 800-990-0340 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TP2701X Psychologist, Group Psychotherapy |
| Additional Taxonomies | 103T00000X Psychologist |
| Enumeration Date | 2010-10-18 |
| Last Update Date | 2011-05-02 |