| NPI | 1154729622 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TANYA MARIE ODANIEL Director 937-726-8629 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: AL 3623C) |
| Enumeration Date | 2014-12-15 |
| Last Update Date | 2014-12-15 |