| NPI | 1124517131 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ZYNASIA JASPER CEO 336-430-7943 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: VA 0701006144) |
| Enumeration Date | 2018-05-04 |
| Last Update Date | 2018-05-04 |