| NPI | 1205634243 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEY ENDLICH Credentialing 740-646-9834 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2025-03-05 |
| Last Update Date | 2025-03-06 |