| NPI | 1942507694 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TREVOR REYNOLDS C.E.O 8054-970-0605 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CA MFC41847) |
| Enumeration Date | 2011-02-15 |
| Last Update Date | 2011-02-15 |