| NPI | 1417684309 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFANY MOORE Owner 678-651-6050 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225600000X Dance Therapist |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| Enumeration Date | 2022-08-02 |
| Last Update Date | 2022-08-09 |