NPI | 1841686078 |
---|---|
Entity Type | Organization |
Authorized Contact | LORI KIM LICHTE-BRILL Chief Clinical Officer 602-910-0526 |
Organization Subpart ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: AZ 4484) |
Additional Taxonomies | 103K00000X Behavior Analyst (Licence: AZ 127) |
Enumeration Date | 2015-04-14 |
Last Update Date | 2015-04-14 |