| NPI | 1205517489 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE STROUTH Office Manager/Administrator 276-298-5034 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 101Y00000X Counselor |
| Enumeration Date | 2023-07-31 |
| Last Update Date | 2024-04-04 |