| NPI | 1023431624 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRY L. FOLLETT Direct Owner 321-301-4591 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: FL MT2050) |
| Enumeration Date | 2014-02-03 |
| Last Update Date | 2014-02-03 |