| NPI | 1699482281 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COLLIN DAVIES Owner 870-532-3406 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 261QM0801X | |
| Enumeration Date | 2022-11-02 |
| Last Update Date | 2023-01-31 |