| NPI | 1962019604 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRYSTAL LOUGIN Owner/ Provider 479-461-7767 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 1041C0700X Social Worker Clinical |
| 101YP2500X Counselor Professional | |
| 106H00000X Marriage & Family Therapist | |
| 171M00000X Case Manager/Care Coordinator | |
| 405300000X Prevention Professional | |
| Enumeration Date | 2020-09-27 |
| Last Update Date | 2020-09-27 |