| NPI | 1164955837 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFANY B TOWNSEND Owner 774-766-8335 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MA 9461) |
| Enumeration Date | 2017-04-09 |
| Last Update Date | 2022-06-01 |