| NPI | 1851875181 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEANETTE WILLIAMS Clinical Director 089-279-6705 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2018-09-22 |
| Last Update Date | 2020-10-03 |