| NPI | 1962944520 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTI A WALTER Sole Member 702-751-2547 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: NV PY0526) |
| Enumeration Date | 2016-11-14 |
| Last Update Date | 2016-11-14 |