| NPI | 1184320285 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CYNTHIA STEPHENS FISHER Sole Member 386-301-2770 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| Enumeration Date | 2023-02-01 |
| Last Update Date | 2023-02-01 |