| NPI | 1912676545 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY AKEHURST Licensed Professional Counselor 475-477-0278 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2021-09-08 |
| Last Update Date | 2021-09-08 |