| NPI | 1013246602 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELISABETH PESCE Secretary 904-605-4986 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MA SW 114188) |
| Enumeration Date | 2009-12-10 |
| Last Update Date | 2022-12-01 |