| NPI | 1588343313 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEXIS MICHELE WOOTEN Pmhnp 419-680-2221 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-07-18 |
| Last Update Date | 2023-07-18 |