| NPI | 1336811462 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER MARTIN Lmft 620-423-5356 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 251S00000X |
| 261Q00000X Clinic/Center | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2021-09-28 |
| Last Update Date | 2021-09-28 |