| NPI | 1033585864 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELINDA KAYE WOODHOUSE Licensed Clinical Therapist 1801-513-0880 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: UT 1312133-3501) |
| Enumeration Date | 2015-08-16 |
| Last Update Date | 2015-08-16 |