| NPI | 1194401034 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHERRI BONCHELE GREEN Owner 270-348-6167 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 225700000X Massage Therapist |
| Enumeration Date | 2023-06-26 |
| Last Update Date | 2023-06-26 |