| NPI | 1376978114 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES HAROLD MARTIN Owner 225-207-5139 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: LA 4250) |
| Enumeration Date | 2013-09-11 |
| Last Update Date | 2013-09-11 |