| NPI | 1871083485 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER SIZEMORE Office Manager 318-861-1090 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: LA 2189) |
| Enumeration Date | 2018-05-18 |
| Last Update Date | 2018-05-18 |