| NPI | 1982295358 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN TILLINGHAST Mental Performance Coach 302-357-0029 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TE1100X Psychologist, Exercise & Sports |
| Enumeration Date | 2021-01-28 |
| Last Update Date | 2021-01-28 |