| NPI | 1912739160 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RACHAEL DESAUSSURE Owner 901-206-2547 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2024-08-16 |
| Last Update Date | 2024-08-16 |