| NPI | 1881610244 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BIANCA WOOD Administrative Manager 857-707-3519 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 103T00000X Psychologist |
| 104100000X Social Worker | |
| 2084P0800X Psychiatry & Neurology Psychiatry | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2006-07-15 |
| Last Update Date | 2023-03-20 |