| NPI | 1861214645 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EMMANUEL NDE Officer 571-365-1833 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TM1800X Psychologist, Intellectual & Developmental Disabilities |
| Enumeration Date | 2024-10-31 |
| Last Update Date | 2024-10-31 |