| NPI | 1083237176 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIELLE BETESH Admin 866-352-5010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| Enumeration Date | 2020-05-22 |
| Last Update Date | 2024-12-10 |