| NPI | 1558233064 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRYSTAL LEE SIPLING Owner 484-416-5263 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 101Y00000X Counselor |
| Enumeration Date | 2025-09-23 |
| Last Update Date | 2025-09-23 |