| NPI | 1902234453 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY M COX Therapist 567-241-1543 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: OH I1200473) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: OH ICDC131026) |
| Enumeration Date | 2013-10-21 |
| Last Update Date | 2022-05-19 |