| NPI | 1447728530 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERALYN RENEE' THARP Mental Health Therapist 937-248-5978 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2018-11-06 |
| Last Update Date | 2018-11-06 |