| NPI | 1093378382 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SELENA WAITE Owner/Psychologist/Counselor 984-212-7373 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| Enumeration Date | 2019-04-22 |
| Last Update Date | 2020-03-19 |