| NPI | 1205468253 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIE TUELLER Owner 928-910-2505 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YP2500X Counselor, Professional | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| Enumeration Date | 2020-02-07 |
| Last Update Date | 2024-02-08 |