| NPI | 1447421003 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WENDY VANCE Billing Specialist 937-592-9545 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 103TC1900X Psychologist, Counseling |
| Enumeration Date | 2008-03-21 |
| Last Update Date | 2008-03-21 |