| NPI | 1467038547 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLIE SHANNON Therapist/Owner 563-209-6033 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2021-03-20 |
| Last Update Date | 2021-03-20 |