| NPI | 1447845821 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANIECE BRIANNE PETERSON JENKINS Outpatient Therapist/Owner 980-275-9119 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2021-03-07 |
| Last Update Date | 2022-08-02 |