| NPI | 1043684608 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA MULLER Lmhc 904-797-5680 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center Adult Mental Health (Licence: FL 12080) |
| Enumeration Date | 2015-11-19 |
| Last Update Date | 2015-11-19 |