| NPI | 1104308899 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICTORIA FITTERLING Billing Manager 870-793-0071 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AR p0405022) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: AR 092L) |
| 106H00000X Marriage & Family Therapist (Licence: AR M0405001) | |
| Enumeration Date | 2018-08-30 |
| Last Update Date | 2018-08-30 |