| NPI | 1285252122 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MALIKA O'NEILL Owner 445-544-3082 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| Enumeration Date | 2020-07-07 |
| Last Update Date | 2020-07-07 |