| NPI | 1225734890 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE GAEDTKE Owner 260-205-8644 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 1041C0700X Social Worker Clinical | |
| Enumeration Date | 2023-02-06 |
| Last Update Date | 2023-02-06 |