| NPI | 1538564802 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY KAREN FILSON Owner 386-295-5101 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| 235Z00000X Speech-Language Pathologist, | |
| 251S00000X Community/Behavioral Health | |
| 261Q00000X Clinic/Center | |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| Enumeration Date | 2014-10-29 |
| Last Update Date | 2020-11-23 |