| NPI | 1194135376 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COLLEEN WEHNER Office Manager 318-517-6222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 104100000X Social Worker |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2014-04-28 |
| Last Update Date | 2014-04-28 |