| NPI | 1487045019 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY S LASTER Partner 4794-268-3958 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: AR P1410084) |
| Enumeration Date | 2015-02-18 |
| Last Update Date | 2015-02-18 |