| NPI | 1588319859 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY HALANSKI CEO 341-888-7637 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2022-02-15 |
| Last Update Date | 2024-06-20 |