| NPI | 1275494577 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NONA LYNN PETERSON Licensed Professional Counselor 662-418-5909 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2025-11-18 |
| Last Update Date | 2025-11-18 |