| NPI | 1235016106 |
|---|---|
| Other Name | SUPPORTIVE CHANGE COUNSELING |
| Entity Type | Organization |
| Authorized Contact | ANTOINE JACKSON Owner / Clinical Director 612-367-7287 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2025-08-20 |
| Last Update Date | 2025-08-20 |