| NPI | 1427827609 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTIE LEE COSTILL Professional Mental Health Counselo 610-675-6380 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Enumeration Date | 2023-12-28 |
| Last Update Date | 2023-12-28 |