Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Professional |
101YP2500X |
| NPI Number | 1093426124 |
| LBN Legal business name | AUTHENTIC SPIRIT COUNSELING SERVICES |
| Authorized official | TIFFANI FRYAR - (OWNER) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 12/09/2022 |
| Last updated | 07/11/2024 - More than a year ago |
| Identifiers | n/a |
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