| NPI | 1396257507 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DECEMBER GOAD President 502-296-9443 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: GA LPC009595) |
| Enumeration Date | 2017-10-27 |
| Last Update Date | 2017-10-27 |