| NPI | 1255028478 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE CHAMBERLAIN Owner/Provider 385-429-0146 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2023-04-18 |
| Last Update Date | 2024-05-16 |