| NPI | 1790174019 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA ETCHISON Owner 501-868-4900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: AR 05-06EI) |
| Enumeration Date | 2015-01-12 |
| Last Update Date | 2015-01-12 |