| NPI | 1326623331 |
|---|---|
| Other Name | BLUE MOUNTAIN THERAPY THERAPEUTIC CONSULTATION |
| Entity Type | Organization |
| Authorized Contact | MELISSA HOPE HENDERSON Office Manager 276-525-4460 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251C00000X |
| Enumeration Date | 2021-03-11 |
| Last Update Date | 2021-03-11 |