| NPI | 1023367570 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURYN SALASSI GILLIAM Owner 305-725-0070 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: TN LMT 1086) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: FL MT 2562) |
| Enumeration Date | 2012-08-30 |
| Last Update Date | 2016-11-16 |