| NPI | 1871301267 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEY JOHNSON Clinician 346-322-5090 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251B00000X Case Management |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 103K00000X Behavior Analyst | |
| Enumeration Date | 2024-12-18 |
| Last Update Date | 2024-12-18 |