| NPI | 1821550500 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KERRY PICKERING Practice Adminstrator 142-356-9364 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 103T00000X Psychologist |
| Enumeration Date | 2019-04-02 |
| Last Update Date | 2019-04-02 |