| NPI | 1962223230 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STELLA PANOS President 424-345-6377 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical |
| Enumeration Date | 2024-10-21 |
| Last Update Date | 2024-10-21 |