| NPI | 1124329388 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRADLEY TODD KINDER Licensed Professional Counselor 276-963-0111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2010-11-04 |
| Last Update Date | 2012-06-11 |