| NPI | 1770139594 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIRIAM MOGILEVSKY Behavioral Health Therapist 937-416-0195 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Enumeration Date | 2019-08-16 |
| Last Update Date | 2019-08-16 |