| NPI | 1093932808 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICIA A KANIUGA Billing 937-426-2686 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical |
| Enumeration Date | 2007-04-20 |
| Last Update Date | 2020-08-22 |