| NPI | 1811498827 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE LIGHTMAN President/ Owner 520-400-8171 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC2200X Psychologist Clinical Child & Adolescent |
| Enumeration Date | 2018-02-25 |
| Last Update Date | 2018-02-25 |