| NPI | 1003515396 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW DAVIS Member 501-351-6068 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2023-02-27 |
| Last Update Date | 2023-02-27 |