|Taxonomy Code||Specialty Code||Provider Type|
|1041C0700X||80||Licensed Clinical Social Worker|
|LBN Legal business name||ALPHA AND OMEGA FAMILY COUNSELING & RESTORATION SERVICES, INC|
|Authorized official||MICHELLE BRYANT - (CEO/PRESIDENT)|
|Organization subpart 1||No|
|Last updated||12/01/2014 - More than a year ago|
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