| NPI | 1912421421 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JADE GIANAKOPOULOS Credentialing Manager 937-206-0377 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: TX 28389) |
| Enumeration Date | 2017-07-27 |
| Last Update Date | 2022-07-21 |