NPI | 1518747567 |
---|---|
Entity Type | Organization |
Authorized Contact | MARY GRACE Clinic Manager 662-325-0621 |
Organization Subpart ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health |
Additional Taxonomies | 103TC0700X Psychologist, Clinical |
Enumeration Date | 2023-10-05 |
Last Update Date | 2025-02-19 |