| NPI | 1619254299 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALONZO HICKERSON Owner Operator 775-379-0748 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: NV C-2101) |
| Enumeration Date | 2011-11-09 |
| Last Update Date | 2011-11-09 |