| NPI | 1164155305 |
|---|---|
| Former Legal Business Name | SELFF RECOVERY COACHING |
| Former Legal Business Name | TYLIE MITCHELL |
| Entity Type | Organization |
| Authorized Contact | TYLIE YOLANDER MITCHELL Owner 191-738-3575 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 103TP2701X Psychologist, Group Psychotherapy |
| Enumeration Date | 2022-07-06 |
| Last Update Date | 2022-07-06 |