| NPI | 1750805503 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHRYN KELLER Owner/Counselor 479-879-6051 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: TX 69060) |
| Enumeration Date | 2017-08-02 |
| Last Update Date | 2017-08-02 |