| NPI | 1063772127 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY J BLANKENBAKER Owner/Counselor 318-332-5090 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: LA 4642) |
| Enumeration Date | 2012-05-23 |
| Last Update Date | 2013-05-14 |