| NPI | 1013359926 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARRIE LYNN PHELPS Director/ Therapist 941-915-8167 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YM0800X Counselor, Mental Health | |
| 101YP2500X Counselor, Professional | |
| Enumeration Date | 2013-07-19 |
| Last Update Date | 2015-08-20 |