| NPI | 1073255311 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMBER SMITH Owner 267-800-5420 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2022-04-08 |
| Last Update Date | 2022-04-08 |