| NPI | 1821820408 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELINA KUGEL Owner 475-203-6400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 103TC0700X Psychologist, Clinical | |
| 103TC2200X Psychologist, Clinical Child & Adolescent | |
| 1041C0700X Social Worker, Clinical | |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2024-08-14 |
| Last Update Date | 2024-11-25 |