| NPI | 1154093326 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA ELENA Owner 480-510-4967 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YM0800X Counselor, Mental Health | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-10-05 |
| Last Update Date | 2021-10-05 |