| NPI | 1306186721 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LILY MAINO Registered Psychotherapist #13780 980-481-9830 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: CO 13780) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: CO 12830) |
| Enumeration Date | 2013-02-21 |
| Last Update Date | 2013-02-21 |