| NPI | 1225875024 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI LONG Owner 276-393-5728 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| Enumeration Date | 2024-07-10 |
| Last Update Date | 2024-07-18 |