| NPI | 1962921973 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURENCIA C.D.L. DUSANTOS Owner 785-375-0375 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: VA 0810005067) |
| Enumeration Date | 2017-09-12 |
| Last Update Date | 2017-09-12 |