| NPI | 1033560347 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIVIAN M MEHNERT Owner 863-604-2535 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH6758) |
| Enumeration Date | 2016-06-28 |
| Last Update Date | 2016-06-28 |