| NPI | 1215623442 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JIMMY JAY L WATKINS Member 229-262-7198 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2023-04-12 |
| Last Update Date | 2023-04-12 |