NPI | 1174977268 |
---|---|
Other Name | TAILORED LIFE |
Entity Type | Organization |
Authorized Contact | LASHARON TAYLOR Licensed Mental Health Counselor 319-217-1375 |
Organization Subpart ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IA 079016) |
Enumeration Date | 2016-04-14 |
Last Update Date | 2016-04-14 |