| NPI | 1265040729 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARISSA MALCOLM Owner 440-753-6287 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101Y00000X Counselor |
| Enumeration Date | 2020-07-21 |
| Last Update Date | 2022-07-22 |