| NPI | 1134715238 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARISSA MITCHELL Licensed Clinical Social Worker 779-242-9571 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2020-12-14 |
| Last Update Date | 2020-12-14 |