| NPI | 1952820243 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TARAH CARMODY KERWIN Partner / Licensed Clinician 520-697-6179 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: AZ CSLG8288) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2017-09-18 |
| Last Update Date | 2024-02-29 |