| NPI | 1356836373 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD OTTESEN Licensed Professional Counselor 859-904-3036 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: AZ LPC-15869) |
| Enumeration Date | 2018-06-22 |
| Last Update Date | 2018-06-22 |