| NPI | 1750826913 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHLEEN FITZWILLIAM LAKEY Owner 385-218-8266 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: UT 7698951-3501) |
| Enumeration Date | 2016-12-27 |
| Last Update Date | 2016-12-30 |