| NPI | 1700387768 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY ELIZABETH FOX Owner 662-470-5433 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MS 2143) |
| Enumeration Date | 2018-02-26 |
| Last Update Date | 2022-09-07 |