| NPI | 1265807903 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHY PUTMAN TWITTY Lpc, Owner 662-665-2457 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MS 1116) |
| Enumeration Date | 2015-12-07 |
| Last Update Date | 2015-12-07 |