| NPI | 1891454294 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMARA MARTINEZ-MORALES Clinical Psychologist/Owner 689-677-2479 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical |
| Additional Taxonomies | 103TA0700X Psychologist Adult Development & Aging |
| 103TB0200X Psychologist Cognitive & Behavioral | |
| 103TC2200X Psychologist Clinical Child & Adolescent | |
| 103TM1800X Psychologist Mental Retardation & Developmental Disabilities | |
| 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2021-12-13 |
| Last Update Date | 2024-05-25 |