| NPI | 1518596113 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMIE SKYTA Owner / Lpc 682-231-1725 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YM0800X Counselor, Mental Health | |
| 101YP2500X Counselor, Professional | |
| Enumeration Date | 2020-04-06 |
| Last Update Date | 2021-01-05 |