| NPI | 1801585625 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY SLAUGHTER Licensed Psychologist 025-303-7885 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2023-05-08 |
| Last Update Date | 2023-05-08 |