| NPI | 1962919886 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YANEISHA GRAHAM LOZANO Owner 219-228-8799 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: IN 39002289A) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: IL 180008040) |
| 103TC1900X Psychologist Counseling | |
| 1041C0700X Social Worker Clinical | |
| Enumeration Date | 2017-12-30 |
| Last Update Date | 2021-09-30 |