| NPI | 1144856915 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA RENEE BLANDING Owner 856-889-8434 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 261QM0801X |
| Enumeration Date | 2020-03-12 |
| Last Update Date | 2020-03-12 |