| NPI | 1316719214 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ITHACA MCCOLLIN Owner 832-510-4664 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2023-10-24 |
| Last Update Date | 2023-10-24 |