| NPI | 1871294041 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN JOSEPH ROCHE Owner/Lpc 315-515-1545 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2023-03-15 |
| Last Update Date | 2023-03-15 |