| NPI | 1134201593 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOLIEN CONNOR Billing Manager 202-641-3750 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WI 2000) |
| Enumeration Date | 2006-10-19 |
| Last Update Date | 2015-06-04 |