| NPI | 1972127850 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN BUCHAN Psychologist 120-938-1043 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical |
| Additional Taxonomies | 103T00000X Psychologist |
| Enumeration Date | 2020-06-05 |
| Last Update Date | 2020-06-05 |