| NPI | 1790299287 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANY L HILLMAN Owner 985-804-1521 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TP0016X Psychologist, Prescribing (Medical) |
| Additional Taxonomies | 103TC1900X Psychologist, Counseling (Licence: LA 1168) |
| Enumeration Date | 2017-11-20 |
| Last Update Date | 2022-11-13 |