| NPI | 1598499394 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA LYNN FOX Owner 740-568-8226 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| Enumeration Date | 2022-07-15 |
| Last Update Date | 2022-07-15 |