| NPI | 1417338849 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE D AVINGER Provider/ Owner 267-235-4263 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MD 19606) |
| Enumeration Date | 2015-06-11 |
| Last Update Date | 2015-06-11 |