| NPI | 1740553080 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK RUSSELL STOBIE Owner/Provider 937-520-8437 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OH E 0501350) |
| Enumeration Date | 2012-02-16 |
| Last Update Date | 2023-03-21 |