| NPI | 1891032652 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICKEY WILLIAMSON President 866-863-4645 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA 20072) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: CA 21442) |
| 103TC0700X Psychologist, Clinical (Licence: CA 23098) | |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: CA 24532) | |
| Enumeration Date | 2013-01-12 |
| Last Update Date | 2018-03-17 |