| NPI | 1013325620 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTINE D PARKER Owner 772-224-2125 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH11674) |
| Enumeration Date | 2014-07-27 |
| Last Update Date | 2014-07-27 |