| NPI | 1992667372 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CASSIE THACKER JACKSON Licensed Professional Counselor 907-888-2082 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Enumeration Date | 2025-11-24 |
| Last Update Date | 2026-01-01 |