| NPI | 1588174304 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACEE MOSS Owner 330-953-1202 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OH E.0004017-SUPV) |
| Enumeration Date | 2017-10-06 |
| Last Update Date | 2024-07-02 |