| NPI | 1336013846 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRYAN T DEERING Owner 772-519-0544 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 2084B0040X Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry |
| Enumeration Date | 2025-09-30 |
| Last Update Date | 2025-11-12 |