| NPI | 1407300049 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARRIE BEAVER Licensed Clinical Counselor 513-266-9581 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305S00000X Point of Service (Licence: OH E.1000112) |
| Enumeration Date | 2016-08-11 |
| Last Update Date | 2016-08-11 |