| NPI | 1679217640 |
|---|---|
| Former Legal Business Name | TRANSITIONING BOY 2 MEN, INC |
| Doing Business As | CREATIVE CONSULTANT COUNSELING AGENCY, INC |
| Entity Type | Organization |
| Authorized Contact | KENDRA LAUDERDALE Clinical Director 405-810-5373 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2022-04-25 |
| Last Update Date | 2025-10-13 |