| NPI | 1508217381 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELSEY ROSE BEALS Managing Partner 937-212-8304 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: SC 2016-36083) |
| Enumeration Date | 2016-06-23 |
| Last Update Date | 2016-06-23 |