| NPI | 1417397951 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLEY NELSON WHITTY-SANDAKER Cd PT Intern 850-218-0752 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA CO60367121) |
| Enumeration Date | 2013-06-28 |
| Last Update Date | 2013-06-28 |