| NPI | 1073080792 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAYLA C. LOUDY Licensed Clinical Social Worker 276-628-2510 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical |
| Enumeration Date | 2018-10-31 |
| Last Update Date | 2018-10-31 |