| NPI | 1215304985 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA GAYLE MCFARLING Clinical Social Worker 270-929-1762 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| Enumeration Date | 2015-08-28 |
| Last Update Date | 2020-11-10 |