| NPI | 1861107955 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA WILKINSON Member 833-378-2552 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101Y00000X Counselor |
| 103T00000X Psychologist | |
| 104100000X Social Worker | |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2023-01-23 |
| Last Update Date | 2023-01-23 |