| NPI | 1265743991 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARRIE MARCERIC Marketing 330-455-0374 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 103TP0016X Psychologist, Prescribing (Medical) |
| Enumeration Date | 2010-06-28 |
| Last Update Date | 2010-06-28 |