| NPI | 1154808400 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANA R GEFROH Owner 701-400-6670 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: ND 6119108236) |
| Enumeration Date | 2018-07-19 |
| Last Update Date | 2018-07-19 |