| NPI | 1831806611 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AIMEE ELLINWOOD Lpc, Lac 540-200-5893 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2022-11-01 |
| Last Update Date | 2023-10-30 |