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Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Professional |
101YP2500X |
| NPI Number | 1346868171 |
| LBN Legal business name | ASPEN GROVE COUNSELING |
| Authorized official | KATY SIMMONS - (CREDENTIALING) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 07/08/2020 |
| Last updated | 07/08/2020 - About 6 years ago |
| Identifiers | n/a |
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ASPEN GROVE COUNSELING
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ASPEN GROVE COUNSELING