| NPI | 1174914360 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBYN LYNN WATCHORN NEWBREY Owner 712-301-6529 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NE 1291) |
| Enumeration Date | 2015-02-10 |
| Last Update Date | 2015-07-01 |