| NPI | 1679633515 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEANNA E MANUEL Director 937-431-3870 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2025-09-11 |