| NPI | 1609875186 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN CHRISTOPHER RYAN COO 479-725-5288 |
| Organization Subpart ? | No |
| Primary Taxonomy | 104100000X Social Worker |
| Additional Taxonomies | 101Y00000X Counselor |
| 103T00000X Psychologist | |
| Enumeration Date | 2005-07-18 |
| Last Update Date | 2018-05-15 |