| NPI | 1790057453 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PRISCILLA ANNE WILSON Owner 402-720-5129 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NE 2417) |
| Enumeration Date | 2012-01-27 |
| Last Update Date | 2012-01-27 |