| NPI | 1275370868 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HOLLY WALTON Manager 207-200-6336 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| Enumeration Date | 2024-07-10 |
| Last Update Date | 2024-07-10 |