| NPI | 1255854428 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANEEN CROSS Clinical Social Worker 267-252-6653 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MD 22754) |
| Enumeration Date | 2017-07-19 |
| Last Update Date | 2017-07-19 |