| NPI | 1669362810 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEOTIA E SMITHERMAN CASTERLOW Owner 336-509-7616 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 101Y00000X Counselor |
| Enumeration Date | 2025-07-08 |
| Last Update Date | 2025-07-08 |