| NPI | 1033939681 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARCKDALINE JOHNSON Owner/Clinical Director 772-577-0981 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist |
| Enumeration Date | 2024-10-16 |
| Last Update Date | 2024-10-16 |