| NPI | 1083289706 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER RAWLS Oncorporator/Organizer/Provider 870-609-0082 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2021-05-25 |
| Last Update Date | 2022-10-05 |