| NPI | 1588419253 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SEPHORA LORTIE Licensed Therapist/Owner 260-619-1603 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2024-04-17 |
| Last Update Date | 2024-04-17 |