| NPI | 1619416054 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROL MARTIN JOHNSON Psychotherapist 267-608-5354 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: PA PC004304) |
| Enumeration Date | 2017-02-17 |
| Last Update Date | 2017-02-17 |