| NPI | 1669084794 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JILLIAN WENDELIN Owner 702-706-4234 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Additional Taxonomies | 261QM0850X Clinic/Center Adult Mental Health |
| Enumeration Date | 2020-08-19 |
| Last Update Date | 2020-08-19 |