| NPI | 1023526514 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KACEY KONWISER DALTON Owner 908-938-4170 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: NJ 37PC00369000) |
| Enumeration Date | 2018-01-18 |
| Last Update Date | 2019-07-05 |