| NPI | 1003103334 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK RICHARD DEARING Licensed Clinical Social Worker 904-477-5678 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: FL SW0000953) |
| Enumeration Date | 2011-07-07 |
| Last Update Date | 2020-02-25 |