| NPI | 1215285671 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN CLARK CORBETT Sole Practitioner 712-281-4068 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IA 1271) |
| Enumeration Date | 2012-08-16 |
| Last Update Date | 2012-08-16 |