| NPI | 1295379436 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VERONICA DENISE WILLIAMS-BENTON Owner 980-230-0638 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2019-10-31 |
| Last Update Date | 2019-10-31 |