| NPI | 1275040859 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BROOKE N SELLHORN Owner 260-409-0609 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2018-01-04 |
| Last Update Date | 2018-01-04 |