| NPI | 1134770829 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIN TAYLOR FOREMAN Licensed Professional Counselor 342-993-6734 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2019-09-24 |
| Last Update Date | 2019-09-24 |