| NPI | 1487877759 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANNON S. LAFORCE Owner 251-343-2993 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AL 1029) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: KS 1029) |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2020-08-22 |