| NPI | 1609691757 |
|---|---|
| Doing Business As | MARY LYNN CAMPBELL |
| Former Legal Business Name | FORGED BY FIRE COUNSELING SERVICES |
| Entity Type | Organization |
| Authorized Contact | MARY LYNN CAMPBELL Owner/CEO 472-208-7904 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 175T00000X Peer Specialist |
| Enumeration Date | 2024-11-22 |
| Last Update Date | 2025-03-31 |