| NPI | 1467800854 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMANTHA L WILLIS Counselor 205-575-8216 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: AL C2613A) |
| Enumeration Date | 2016-05-26 |
| Last Update Date | 2016-09-07 |