| NPI | 1164912853 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN J BROWN Owner 985-377-6983 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: LA LA-4964) |
| Enumeration Date | 2018-05-17 |
| Last Update Date | 2020-01-17 |