| NPI | 1043964380 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA C CLEARY Licensed Professional Counselor 662-415-2553 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-02-06 |
| Last Update Date | 2022-02-06 |