| NPI | 1376207811 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CESSEL JEWON BOYD Owner 984-219-7524 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| Enumeration Date | 2021-10-29 |
| Last Update Date | 2021-10-29 |