| NPI | 1558955641 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRENECSIA WILSON Owner 253-268-6034 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2021-03-01 |
| Last Update Date | 2021-03-01 |