| NPI | 1912026717 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WAYNE POPPALARDO Psychologist 856-428-6644 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: PA PS003474L) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: NJ 00951) |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2020-08-22 |