| NPI | 1356919922 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WYANICKA BROUSSARD Licensed Professional Counselor 346-327-5161 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251B00000X Case Management |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 101YP2500X Counselor, Professional | |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2021-06-11 |
| Last Update Date | 2024-06-12 |