A psychologist, certified/licensed at the independent practice level in his/her state, who is duly trained and experienced in the delivery of direct, preventative, assessment, and therapeutic intervention services to individuals whose growth, adjustment, or functioning is actually impaired or is demonstrably at high risk of impairment (1974).
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Health Service |
103TH0100X | 62 | Psychologist, Clinical |
| NPI Number | 1457194656 |
| LBN Legal business name | FRONTLINE HEALTHCARE |
| Authorized official | MILLICENT BRANDON-PORTER - (CEO) |
| Entity | Organization |
| Organization subpart 1 | Yes |
| Enumeration date | 06/15/2024 |
| Last updated | 06/15/2024 - More than a year ago |
| Identifiers | n/a |
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