| NPI | 1578320016 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALLY CARDENAS Credentialing Specialists 740-586-0881 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2024-03-01 |
| Last Update Date | 2024-03-01 |