Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Mental Health (Including Community Mental Health Center) |
261QM0801X | B4[14] | Community Mental Health Center | |
Clinical |
103TC0700X | 62 | Psychologist, Clinical |
| NPI # | 1295367449 |
| LBN Legal business name | WINDS OF CHANGE COUNSELING SERVICES LLC |
| Authorized official | SHELLY HALL - (CLINICAL PSYCHOLOGICAL) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 02/05/2020 |
| Last updated | 09/23/2020 - About 6 years ago |
| Identifiers | n/a |
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