NPI | 1437784188 |
---|---|
Entity Type | Organization |
Authorized Contact | JESSICA LAUREN FOKSA Owner 269-389-0432 |
Organization Subpart ? | No |
Primary Taxonomy | 101Y00000X Counselor |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
101YP2500X Counselor, Professional | |
103T00000X Psychologist | |
1041C0700X Social Worker, Clinical | |
Enumeration Date | 2020-03-03 |
Last Update Date | 2023-09-21 |