| NPI | 1215457544 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE STILTNER Manager 606-200-3450 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2017-06-27 |
| Last Update Date | 2022-07-21 |