NPI | 1285919977 |
---|---|
Entity Type | Organization |
Authorized Contact | MATTHEW JOHN MARTENSON Owner 563-424-2016 |
Organization Subpart ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IA 00728) |
Enumeration Date | 2011-10-13 |
Last Update Date | 2023-12-28 |