| NPI | 1053983148 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRITTANY R PRATT Administrator 740-249-4514 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 103TA0400X Psychologist, Addiction (Substance Use Disorder) |
| Enumeration Date | 2021-07-16 |
| Last Update Date | 2022-04-29 |