| NPI | 1023255106 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACOB CORKLIN Owner/Therapist 479-387-0110 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MO 2008036432) |
| Enumeration Date | 2009-01-12 |
| Last Update Date | 2023-12-15 |