| NPI | 1467395517 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JILLIAN NEIKAM Authorized Official 570-599-6514 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2026-04-13 |
| Last Update Date | 2026-04-18 |