| NPI | 1073252995 | 
|---|---|
| Doing Business As | SPRING TIDE THERAPY | 
| Entity Type | Organization | 
| Authorized Contact | AMANDA FREY Owner 419-345-7404 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 101YP2500X Counselor, Professional | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health | 
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2022-05-31 | 
| Last Update Date | 2022-06-13 |