| NPI | 1922863174 |
|---|---|
| Other Name | ISAIAH MANTOOTH-JORDAN |
| Entity Type | Organization |
| Authorized Contact | ISAIAH MANTOOTH-JORDAN Owner 716-418-3885 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2024-02-16 |
| Last Update Date | 2024-07-30 |