| NPI | 1679822829 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEREK JOSHUA LEE Member 419-482-8382 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OH E.0900398) |
| Enumeration Date | 2012-09-04 |
| Last Update Date | 2012-09-04 |