| NPI | 1528440385 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CONNIE SUE NICHOLS Director 712-389-0799 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NE 1274) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: NE 4057) |
| 101YP2500X Counselor, Professional (Licence: NE 1999) | |
| Enumeration Date | 2015-06-29 |
| Last Update Date | 2015-06-29 |