| NPI | 1922408061 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EVAN FREEDMAN Member 360-734-2664 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 103TF0200X Psychologist, Forensic |
| Enumeration Date | 2014-08-26 |
| Last Update Date | 2014-08-26 |