| NPI | 1700659190 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTEN R LADNER Mental Health Therapist 228-224-1082 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2023-11-06 |
| Last Update Date | 2023-11-06 |