NPI | 1528505369 |
---|---|
Entity Type | Organization |
Authorized Contact | JACOB DONAVON SCHAEFER Owner 319-239-3533 |
Organization Subpart ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IA 001292) |
Enumeration Date | 2017-01-31 |
Last Update Date | 2017-03-30 |