| NPI | 1912705872 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CORTNEY G LANSANAH Licensed Professional Clinical Coun 220-228-6798 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Enumeration Date | 2025-03-06 |
| Last Update Date | 2025-03-06 |