| NPI | 1760738231 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBIN DALEKE Licensed Clinical Social Worker 662-609-1899 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MS C5591) |
| Enumeration Date | 2012-08-01 |
| Last Update Date | 2012-08-01 |