NPI | 1093366775 |
---|---|
Entity Type | Organization |
Authorized Contact | KATHRYN KIM WAGGONER CEO 228-819-2171 |
Organization Subpart ? | No |
Primary Taxonomy | 103TH0004X Psychologist, Health |
Additional Taxonomies | 101Y00000X Counselor |
101YM0800X Counselor, Mental Health | |
101YP2500X Counselor, Professional | |
103T00000X Psychologist | |
103TC0700X Psychologist, Clinical | |
Enumeration Date | 2019-09-24 |
Last Update Date | 2024-06-10 |