| NPI | 1194478420 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BETHANY OTTEN Owner/ Counselor 704-702-6448 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101Y00000X Counselor |
| Enumeration Date | 2022-01-27 |
| Last Update Date | 2024-07-31 |