| NPI | 1205646775 |
|---|---|
| Doing Business As | MOON RISING, LLC |
| Entity Type | Organization |
| Authorized Contact | VIRGINIA WALLS Owner 850-270-7295 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YP2500X Counselor, Professional | |
| 103TP2701X Psychologist, Group Psychotherapy | |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2025-01-08 |
| Last Update Date | 2025-01-08 |