| NPI | 1386501534 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAZZMEN DAVIS Practice Owner/Clinical Director 980-990-2642 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 251B00000X Case Management |
| Enumeration Date | 2026-01-08 |
| Last Update Date | 2026-01-08 |