| NPI | 1619525763 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREA BANKS RAIMEY Owner 937-550-8996 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2019-09-02 |
| Last Update Date | 2019-09-25 |