NPI | 1588357768 |
---|---|
Entity Type | Organization |
Authorized Contact | COURTNEY ELIZABETH BACON-LATINA Therapist; Owner 501-802-0107 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
Enumeration Date | 2023-06-01 |
Last Update Date | 2023-06-01 |