| NPI | 1942721345 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMANTHA MARIE GILKERSON Mental Health Therapist 308-760-5041 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: NE 11187) |
| Enumeration Date | 2017-07-06 |
| Last Update Date | 2017-07-06 |