| NPI | 1013613694 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRYSTAL MARCO Owner 267-306-0824 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2023-02-06 |
| Last Update Date | 2023-02-06 |