| NPI | 1932721206 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER DENNIS Md 888-515-3834 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical |
| 1041C0700X Social Worker, Clinical | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| 363A00000X Physician Assistant | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2020-05-10 |
| Last Update Date | 2024-03-14 |