| NPI | 1497450738 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA A REINERS Credentialing & Contracting 731-571-9223 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2023-04-04 |
| Last Update Date | 2023-04-04 |