| NPI | 1376173401 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA KENNINGTON Social Worker 870-330-4095 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| Enumeration Date | 2020-01-16 |
| Last Update Date | 2025-09-17 |