| NPI | 1053789735 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KASEY GENTRY WITHERINGTON Licensed Professional Counselor 318-381-4221 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: LA 3816) |
| Additional Taxonomies | 251S00000X (Licence: LA 3816) |
| Enumeration Date | 2015-09-11 |
| Last Update Date | 2015-09-11 |