| NPI | 1912406059 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFANY BOWDEN CEO 857-242-1139 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251B00000X Case Management (Licence: IN 28340) |
| Additional Taxonomies | 102L00000X Psychoanalyst (Licence: IN 28340) |
| Enumeration Date | 2018-02-05 |
| Last Update Date | 2018-02-05 |