| NPI | 1689183329 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY L WILSON Owner 913-486-5147 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: KS 3094) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: KS 3094) |
| Enumeration Date | 2017-09-26 |
| Last Update Date | 2022-07-21 |