| NPI | 1013605336 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY LYNN WINGSTER Lpc, Owner 907-252-8878 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-04-25 |
| Last Update Date | 2023-04-25 |