| NPI | 1205349156 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MANICKA THOMAS Clinical Director 937-204-9013 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OH I.1700639) |
| Enumeration Date | 2017-11-14 |
| Last Update Date | 2018-06-16 |