| NPI | 1295489326 |
|---|---|
| Former Legal Business Name | N/A |
| Entity Type | Organization |
| Authorized Contact | GWENDOLYN WILSON Licensed Professional Counselor 205-523-2912 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Enumeration Date | 2022-02-08 |
| Last Update Date | 2022-02-08 |