| NPI | 1790503704 |
|---|---|
| Former Legal Business Name | IZAAK DAVISON-KERWOOD, LLC |
| Entity Type | Organization |
| Authorized Contact | IZAAK RIVER DAVISON-KERWOOD CEO 612-850-1006 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2024-09-30 |
| Last Update Date | 2024-09-30 |