| NPI | 1255407698 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JD WILLETTS Director 302-738-6859 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 103T00000X Psychologist |
| 104100000X Social Worker | |
| 225700000X Massage Therapist | |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2020-08-22 |