| NPI | 1750944005 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACKY SHAY HOWARD Billing Official 888-623-8890 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 1041C0700X Social Worker, Clinical | |
| 101YP2500X Counselor, Professional | |
| Enumeration Date | 2019-04-22 |
| Last Update Date | 2026-02-01 |