| NPI | 1336872449 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEXA THOMPSON Owner 888-765-4465 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2022-07-06 |
| Last Update Date | 2022-07-06 |