| NPI | 1780492876 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEWYL TUCKER Managing Member 980-330-2215 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| Enumeration Date | 2024-12-21 |
| Last Update Date | 2025-01-07 |