| NPI | 1942022959 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAM GEORGE Manager 302-440-6112 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TM1800X Psychologist, Intellectual & Developmental Disabilities |
| Enumeration Date | 2024-10-30 |
| Last Update Date | 2024-10-30 |