| NPI | 1295258101 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEATHER W BLACK Therapist/ Owner 228-365-2317 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MS C5680) |
| Enumeration Date | 2017-07-23 |
| Last Update Date | 2018-02-07 |