| NPI | 1912753328 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANICE COBURN Clinical Manager/Owner 501-358-9625 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2024-04-26 |
| Last Update Date | 2024-04-26 |