| NPI | 1760080048 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGIE CONWAY Owner 682-237-9562 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| Enumeration Date | 2020-10-09 |
| Last Update Date | 2020-10-09 |