| NPI | 1790169464 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARSHALEE LATOYA HANSON-GROTZ Licensed (Therapist) Professional C 267-242-9819 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: PA PC006926) |
| Enumeration Date | 2015-07-13 |
| Last Update Date | 2023-12-11 |