| NPI | 1285202366 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BROOKE C. WILSON Owner/Counselor 937-367-9242 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 251S00000X |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2021-06-15 |
| Last Update Date | 2021-06-15 |