| NPI | 1831665462 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY SHEREE BAILEY Owner 769-218-8298 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical |
| Additional Taxonomies | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2018-10-22 |
| Last Update Date | 2025-07-14 |