| NPI | 1023484300 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARRIE LYNN PHELPS Therapst /Owner 941-488-4811 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2015-08-20 |
| Last Update Date | 2015-08-25 |