| NPI | 1942642095 |
|---|---|
| Doing Business As | KEYSTONE PSYHCOLOGICAL GROUP |
| Entity Type | Organization |
| Authorized Contact | CHRISTINE MACMILLAN Medical Director 917-549-0215 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NJ 25MA07642800) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: NJ 37PC00038100) |
| 1041C0700X Social Worker, Clinical (Licence: NJ 44SC00138300) | |
| 106H00000X Marriage & Family Therapist (Licence: NJ 37FI00160600) | |
| Enumeration Date | 2013-07-17 |
| Last Update Date | 2013-07-17 |