| NPI | 1326798943 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDMUND JASON STAMPER Founder Member 605-600-3733 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YP2500X Counselor, Professional | |
| Enumeration Date | 2022-03-26 |
| Last Update Date | 2022-03-26 |