| NPI | 1124584636 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFF KOLACZKOWSKI Owner 937-223-1781 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 1041C0700X Social Worker, Clinical | |
| 221700000X Art Therapist | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2019-02-20 |
| Last Update Date | 2020-03-11 |