| NPI | 1336994805 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMANTHA AGAN Owner 641-895-2149 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 104100000X Social Worker |
| Enumeration Date | 2024-04-18 |
| Last Update Date | 2024-04-22 |