| NPI | 1245879022 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARRYSE A JOHNSON Owner 980-701-4192 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 103TB0200X Psychologist, Cognitive & Behavioral | |
| Enumeration Date | 2019-12-27 |
| Last Update Date | 2019-12-27 |