| NPI | 1619384583 |
|---|---|
| Former Legal Business Name | INNER TRANSFORMATION THERAPEUTIC SERVICES, PLLC |
| Entity Type | Organization |
| Authorized Contact | CORRELIA D JOHNSON Owner 980-230-8880 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2014-07-12 |
| Last Update Date | 2022-08-26 |