| NPI | 1679633515 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEANNA E MANUEL Director 937-431-3870 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional |
| Additional Taxonomies | 103TC0700X Psychologist Clinical |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2020-08-22 |