| NPI | 1255003000 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIRRANDA CARDINALI Owner/Operator 636-600-0446 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 133V00000X Dietitian, Registered | |
| Enumeration Date | 2021-09-30 |
| Last Update Date | 2025-10-27 |