| NPI | 1003329913 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOMINQUE SEQUIOA HAMRICK Co Owner 980-200-5370 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2017-11-14 |
| Last Update Date | 2017-11-14 |