| NPI | 1598409997 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATALIE SAMUELS Clinical Director 980-293-1995 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| Enumeration Date | 2022-04-22 |
| Last Update Date | 2023-08-29 |