| NPI | 1023880234 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAYLA WILSON Owner 737-293-7411 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 104100000X Social Worker |
| Enumeration Date | 2023-10-23 |
| Last Update Date | 2023-10-24 |