| NPI | 1295540110 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDEA MARIE PETROVICH Licensed Mental Health Counselor 963-359-9539 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2025-02-10 |
| Last Update Date | 2025-02-10 |