| NPI | 1790407518 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFANY M CHESNUT Licensed Professional Counselor 205-901-6353 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-09-19 |
| Last Update Date | 2022-09-19 |