| NPI | 1114676061 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNA DWYER SKINNER Owner 267-458-2927 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YP2500X Counselor, Professional | |
| Enumeration Date | 2022-03-19 |
| Last Update Date | 2022-03-19 |