| NPI | 1639944630 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOAN ANDRES Owner/Provider 712-360-0399 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2023-11-20 |
| Last Update Date | 2023-11-20 |