| NPI | 1093598591 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRYSTAL RALEY Counselor 430-257-8181 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| 101YM0800X Counselor Mental Health | |
| 101YP2500X Counselor Professional | |
| Enumeration Date | 2023-08-17 |
| Last Update Date | 2023-08-17 |