| NPI | 1902649494 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VALENCIA ANNAZETTE JONES Owner 318-200-0341 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2024-06-13 |
| Last Update Date | 2024-06-13 |