| NPI | 1467912220 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENI LYNN LABBE Owner 774-469-0522 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2019-03-20 |
| Last Update Date | 2020-08-24 |