| NPI | 1871970566 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES M MISJA President 937-260-3156 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 103G00000X Clinical Neuropsychologist | |
| 103TC1900X Psychologist, Counseling | |
| Enumeration Date | 2015-05-01 |
| Last Update Date | 2015-05-01 |