| NPI | 1558563296 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHELLY RAE TOMPKINS Managing Member & Provider 740-622-7010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OH E-0003948) |
| Enumeration Date | 2007-06-04 |
| Last Update Date | 2008-03-05 |