| NPI | 1922278563 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN FRAGER Billing Manager 636-464-8422 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: NJ MA042633) |
| Enumeration Date | 2008-03-11 |
| Last Update Date | 2008-03-11 |