| NPI | 1851029516 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY HALANSKI Director 877-644-6008 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 2084N0400X Psychiatry & Neurology, Neurology | |
| Enumeration Date | 2022-08-10 |
| Last Update Date | 2023-06-15 |