| NPI | 1902292469 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CINDY RENEE JACOBS Owner/Therapist 620-371-6548 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: KS LCPC2407) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: KS LAC1019) |
| Enumeration Date | 2015-04-11 |
| Last Update Date | 2015-04-11 |