| NPI | 1255051611 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALICIA CEYNAR License 682-238-0211 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2022-08-29 |
| Last Update Date | 2022-08-29 |