| NPI | 1750127114 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARISSA ERICKSON Licensed Professional Counselor 682-395-9126 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2024-07-05 |
| Last Update Date | 2024-08-23 |