| NPI | 1659185171 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RESHAWNDA RICHARDSON Manager 424-470-5946 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Additional Taxonomies | 1041C0700X Social Worker Clinical |
| Enumeration Date | 2025-02-05 |
| Last Update Date | 2025-02-05 |