| NPI | 1649710997 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMARA BONCIA BLACKEDGE BURR Owner/Therapist 205-777-1716 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: AL 3674C) |
| Enumeration Date | 2017-03-06 |
| Last Update Date | 2017-03-06 |