| NPI | 1609590652 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY HALANSKI President 341-888-7637 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2022-10-03 |
| Last Update Date | 2022-10-03 |