| NPI | 1104287937 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BENTE HESS JOHNSON Sole Member 601-600-2429 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MS C4173) |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| 235Z00000X Speech-Language Pathologist, | |
| Enumeration Date | 2016-03-07 |
| Last Update Date | 2016-03-07 |