| NPI | 1487316808 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACEY BRISTOW Owner 740-807-1506 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2021-10-13 |
| Last Update Date | 2022-03-28 |