| NPI | 1932522356 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER LARA DOUGALL Professional Clinical Counselor 330-805-4587 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: OH E 0007143) |
| Enumeration Date | 2014-01-22 |
| Last Update Date | 2014-03-06 |