| NPI | 1417311473 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CORTNEY MARIE BANKS Mental Health Therapist 937-457-2870 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: OH C.1001000) |
| Enumeration Date | 2016-04-06 |
| Last Update Date | 2016-04-06 |