| NPI | 1609316959 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COURTNEY MAHAIRAS President/Clinical Director 386-492-9041 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 103K00000X Behavior Analyst | |
| Enumeration Date | 2017-03-06 |
| Last Update Date | 2024-10-01 |