| NPI | 1003099516 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATTI K HALL Secretary/Treasurer 386-761-2390 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL SW3855) |
| Additional Taxonomies | 251S00000X (Licence: FL SW3855) |
| Enumeration Date | 2007-12-07 |
| Last Update Date | 2007-12-07 |