| NPI | 1386991230 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIRA JOHNSON Clinical Service Director 769-233-8585 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MS C6696) |
| Enumeration Date | 2012-08-10 |
| Last Update Date | 2015-06-22 |