| NPI | 1174853196 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES CHRISTIAN WHITLOCK Owner 267-334-3735 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: PA CW016312) |
| Enumeration Date | 2010-01-14 |
| Last Update Date | 2010-01-14 |