| NPI | 1003095779 |
|---|---|
| Former Legal Business Name | NONE |
| Entity Type | Organization |
| Authorized Contact | PAUL M WEISEMANN Director/Therapist 813-643-2600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Enumeration Date | 2007-10-30 |
| Last Update Date | 2013-05-24 |