| NPI | 1639594195 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROLYN FAUCETTE Psychotherapist 330-318-3436 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: OH I0900303) |
| Additional Taxonomies | 251S00000X (Licence: PA BH001192) |
| Enumeration Date | 2014-02-20 |
| Last Update Date | 2014-02-20 |