| NPI | 1871237370 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUKE JANA Chief Administrative Officer 855-223-7123 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| Enumeration Date | 2022-04-21 |
| Last Update Date | 2022-04-21 |