| NPI | 1861166753 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASMINE RENEE' GULLEY License Professional Counselor 870-345-8206 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2021-08-04 |
| Last Update Date | 2021-08-04 |