| NPI | 1992289946 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY ELIZABETH DRURY Member/Owner 346-291-5694 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2018-09-15 |
| Last Update Date | 2018-09-15 |