| NPI | 1548079700 | 
|---|---|
| Doing Business As | CHASTIDY BOUTIN | 
| Entity Type | Organization | 
| Authorized Contact | CHASTIDY BOUTIN Owner/Operator 706-341-2745  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical | 
| Enumeration Date | 2025-01-02 | 
| Last Update Date | 2025-01-07 |