| NPI | 1003322264 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TANESHA T BURNS Mental Health Counselor 407-431-7866 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: FL MH15463) |
| Enumeration Date | 2017-12-22 |
| Last Update Date | 2017-12-22 |