| NPI | 1205208121 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER FENSKE-DOYLE Sole Member 937-439-2984 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OH I.0009170-SUPV) |
| Enumeration Date | 2015-10-30 |
| Last Update Date | 2023-01-19 |