| NPI | 1821420357 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOLLY J DOUGLAS Sole Member 515-468-0364 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IA 001175) |
| Enumeration Date | 2013-08-07 |
| Last Update Date | 2013-08-07 |