| NPI | 1033470331 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTEN TOLBERT Owner 321-212-8651 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: FL IMH 6814) |
| Enumeration Date | 2012-06-04 |
| Last Update Date | 2012-06-04 |