| NPI | 1962111948 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANA VIRGINIA TAVERAS Licensed Professional Counselor 475-999-2619 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional |
| Enumeration Date | 2022-11-18 |
| Last Update Date | 2022-11-18 |