| NPI | 1386339976 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE F MUNCY CEO 769-355-9039 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2023-04-10 |
| Last Update Date | 2025-10-22 |