| NPI | 1083404271 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMORY BALLANTINE Owner/Therapist 360-518-4770 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2025-05-09 |
| Last Update Date | 2025-05-09 |