| NPI | 1407208390 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CIARA WARDEN Co Owner 712-256-9902 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IA 001147) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: IA 007763) |
| Enumeration Date | 2016-07-05 |
| Last Update Date | 2016-07-05 |