| NPI | 1689560211 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAQUANA HICKS Owner 910-518-0015 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| Enumeration Date | 2025-06-18 |
| Last Update Date | 2025-06-18 |