| NPI | 1215309869 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN BENSON FEEMSTER Psychotherapist 980-307-0720 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: SC 6206) |
| Enumeration Date | 2015-10-22 |
| Last Update Date | 2015-10-22 |