| NPI | 1932739166 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHTIN DICOCHEA Owner 910-705-1698 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 251S00000X | |
| Enumeration Date | 2020-01-15 |
| Last Update Date | 2022-09-29 |