| NPI | 1003851411 |
|---|---|
| Former Legal Business Name | FAMILY SERVICE AGENCY |
| Entity Type | Organization |
| Authorized Contact | TIFFANY NELSON Office Manager 937-325-5564 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OH 0284) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH 0284) |
| 106H00000X Marriage & Family Therapist (Licence: OH 0284) | |
| Enumeration Date | 2006-06-19 |
| Last Update Date | 2023-06-15 |