| NPI | 1639056260 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENDALL SMALL Managing Owner/Clinical Therapist 980-521-7089 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2025-08-18 |
| Last Update Date | 2025-08-18 |