| NPI | 1982128674 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE ANN CARUSO Owner 330-501-7821 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: OH I.1500779-SUPV) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: OH E.0600050-SUPV) |
| Enumeration Date | 2017-08-03 |
| Last Update Date | 2017-10-23 |