| NPI | 1063989788 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALLISON HANSEN Clinical Mental Health Counselor/Ad 385-250-9255 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2018-10-31 |
| Last Update Date | 2018-10-31 |