| NPI | 1831573864 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BERNARD JAMES MCNAMARA Owner 339-368-1139 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YM0800X Counselor, Mental Health | |
| 101YS0200X Counselor, School | |
| 103T00000X Psychologist | |
| 103TB0200X Psychologist, Cognitive & Behavioral | |
| 103TC1900X Psychologist, Counseling | |
| 103TC2200X Psychologist, Clinical Child & Adolescent | |
| 103TS0200X Psychologist, School | |
| Enumeration Date | 2015-07-20 |
| Last Update Date | 2015-07-20 |