| NPI | 1689985566 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON TODD CAVIN Director 866-278-3194 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA LPC006387) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: 1-12-12287) |
| Enumeration Date | 2010-06-25 |
| Last Update Date | 2014-09-17 |