| NPI | 1356748222 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA DORLAND Managing Member/Owner 520-302-4116 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: AZ LPC-14423) |
| Enumeration Date | 2014-11-20 |
| Last Update Date | 2014-11-20 |