| NPI | 1952406845 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAMILAH MCPHAIL MCKISSICK Clinical Director / Licensed Psycol 980-214-4281 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2016-11-15 |