| NPI | 1992259535 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANE C KIRK Clinical Psychologist 302-545-5353 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: OK 1234) |
| Enumeration Date | 2016-08-11 |
| Last Update Date | 2016-08-11 |