| NPI | 1588470108 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICIA WATLINGTON Owner 432-202-3067 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2024-12-09 |
| Last Update Date | 2026-05-29 |