| NPI | 1346697158 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER REISBERG Member 330-472-9667 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA MC60613549) |
| Enumeration Date | 2016-05-21 |
| Last Update Date | 2016-05-21 |