| NPI | 1871088369 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BEVERLY FORREY Owner 765-210-1284 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2018-06-27 |
| Last Update Date | 2021-08-12 |