| NPI | 1467188136 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAITLIN OBERG Owner 716-361-4899 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2022-07-26 |
| Last Update Date | 2023-01-26 |