| NPI | 1174393771 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA BARABY Owner 774-264-1249 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 251S00000X |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2024-01-04 |
| Last Update Date | 2024-01-04 |