| NPI | 1790077543 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROXANA LAMBDIN Operating Manager/ Provider 888-568-5640 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA PSY15130) |
| Enumeration Date | 2011-05-12 |
| Last Update Date | 2011-05-12 |