| NPI | 1124619333 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER WIESE Owner 605-215-1701 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YA0400X Counselor Addiction (Substance Use Disorder) | |
| 101YP2500X Counselor Professional | |
| Enumeration Date | 2021-01-30 |
| Last Update Date | 2023-02-24 |