| NPI | 1063163301 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MEAGAN MONTGOMERY Owner 812-701-2701 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| Enumeration Date | 2022-01-18 |
| Last Update Date | 2022-02-02 |