| NPI | 1790558195 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIANELA PENA-MARTINEZ Clinical Psychologist 754-304-6378 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| Enumeration Date | 2023-11-07 |
| Last Update Date | 2023-11-07 |