| NPI | 1245983824 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATASHA REGINA PORTER CEO/Clinical Director 270-900-1358 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| Enumeration Date | 2022-02-02 |
| Last Update Date | 2022-09-17 |