| NPI | 1992279657 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBORA K WALLACE-WOOD Clinical Counselor 614-441-5419 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2019-01-16 |
| Last Update Date | 2019-06-11 |