| NPI | 1033977350 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA R ERICKSON Owner 321-202-7445 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2024-03-11 |
| Last Update Date | 2024-03-14 |