| NPI | 1821314808 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHELIE D. LEIGHTER Owner 712-256-9660 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IA 06799) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: IA 06799) |
| Enumeration Date | 2010-04-15 |
| Last Update Date | 2019-11-19 |