| NPI | 1801148739 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KYSETA WARNER-ARMSTRONG Provider 662-470-6485 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MS 1007) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MS C5871) |
| Enumeration Date | 2012-10-02 |
| Last Update Date | 2012-10-02 |