| NPI | 1912281486 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHUNG HORTON JEFFERSON Managing Member 702-401-3632 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2011-10-03 |
| Last Update Date | 2016-04-20 |