| NPI | 1770165482 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEXANDRA LEE VERICKER Owner/Therapist 870-307-3624 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services |
| Enumeration Date | 2021-04-22 |
| Last Update Date | 2021-04-22 |