| NPI | 1427772904 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SONSERAY TASHIA LUSTER Clinical Social Worker/Therapist 330-541-7450 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical |
| Enumeration Date | 2022-09-28 |
| Last Update Date | 2022-09-28 |