| NPI | 1952951394 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SIERRA-DOREEN WONG Managing Member 520-505-1751 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Enumeration Date | 2019-09-18 |
| Last Update Date | 2021-07-13 |