| NPI | 1427895846 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | TODD ANDREW THAMES President 800-997-6196  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 103T00000X Psychologist | 
| Additional Taxonomies | 101Y00000X Counselor | 
| 104100000X Social Worker | |
| Enumeration Date | 2024-07-12 | 
| Last Update Date | 2024-10-16 |