| NPI | 1366815268 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KORY MARLENE WOOD Licensed Professional Counselor/Own 318-229-6236 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2015-11-02 |
| Last Update Date | 2019-07-24 |