| NPI | 1003451766 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRI K LANKFORD Owner 984-244-2111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 101YP2500X Counselor, Professional | |
| Enumeration Date | 2019-11-16 |
| Last Update Date | 2019-11-16 |