| NPI | 1295531101 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MALLORY ROGERS Owner 984-355-9618 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2025-02-21 |
| Last Update Date | 2025-02-21 |