| NPI | 1669859559 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES M MISJA President 937-260-3156 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084B0040X Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YM0800X Counselor, Mental Health | |
| 103K00000X Behavior Analyst | |
| 103TC1900X Psychologist, Counseling | |
| Enumeration Date | 2015-04-30 |
| Last Update Date | 2015-04-30 |