| NPI | 1093191041 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIRIAH GARRARD Partner 270-228-0340 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YP2500X Counselor, Professional | |
| 1041C0700X Social Worker, Clinical | |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2015-07-31 |
| Last Update Date | 2021-02-06 |