| NPI | 1992318893 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA M STEVENS CEO 877-815-8845 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical |
| Enumeration Date | 2020-08-28 |
| Last Update Date | 2022-09-08 |