| NPI | 1861226342 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICAELA WAMBOLDT Lpc 480-757-5885 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 171400000X Health & Wellness Coach |
| Enumeration Date | 2024-08-28 |
| Last Update Date | 2024-10-07 |