| NPI | 1013649250 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY HOPE HUDDLESTON Member 606-404-5105 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YP2500X Counselor, Professional | |
| Enumeration Date | 2022-06-27 |
| Last Update Date | 2023-04-27 |