| NPI | 1053778985 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE M HOLBROOK Professional Clinical Counselor 937-776-4339 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OH E. 0600268) |
| Enumeration Date | 2016-01-22 |
| Last Update Date | 2016-01-22 |