| NPI | 1902464621 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN MARIE CLARK Professional Clinical Counselor 330-968-8224 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Enumeration Date | 2019-05-29 |
| Last Update Date | 2019-05-29 |