Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Professional |
101YP2500X |
| NPI Number | 1851030951 |
| LBN Legal business name | AVALON COUNSELING AND WELLNESS CENTER LLC |
| Authorized official | DIANA DASH - (OWNER) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 05/27/2022 |
| Last updated | 05/27/2022 - About 4 years ago |
| Identifiers | n/a |
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