| NPI | 1194387787 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TISHOUNNA KNOX SULTON Owner/Clinical Psychotherapist 769-216-0815 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical |
| Enumeration Date | 2019-07-03 |
| Last Update Date | 2019-07-03 |