| NPI | 1336455070 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KASEY GENTRY WITHERINGTON Licensed Professional Counselor 318-330-9728 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: LA 2308) |
| Enumeration Date | 2010-08-19 |
| Last Update Date | 2010-08-19 |