| NPI | 1477088938 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMARA S. MADDEN Sole Mbr 620-200-0234 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: KS 3929) |
| Enumeration Date | 2017-04-21 |
| Last Update Date | 2017-05-10 |