| NPI | 1972073229 |
|---|---|
| Former Legal Business Name | PROVIDENCE VIEW COUNSELING & PLAY THERAPY |
| Entity Type | Organization |
| Authorized Contact | JENNIFER COBB Owner 704-659-6220 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Enumeration Date | 2018-11-29 |
| Last Update Date | 2018-11-29 |