| NPI | 1073350492 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TODD ANDREW THAMES President 800-997-6196 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 101Y00000X Counselor |
| 104100000X Social Worker | |
| Enumeration Date | 2024-07-12 |
| Last Update Date | 2024-10-16 |