| NPI | 1265120182 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANELLE PURDY Therapist 808-864-6863 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2023-04-27 |
| Last Update Date | 2024-11-15 |