| NPI | 1215762679 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEXANDRA COYNE Lpc Supervisee 605-389-2571 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2024-09-05 |
| Last Update Date | 2024-09-05 |