| NPI | 1720802341 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AUTUM BRECKENRIDGE Billing And Credentialing 870-243-3644 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2024-11-11 |
| Last Update Date | 2024-11-11 |