| NPI | 1053030643 |
|---|---|
| Former Legal Business Name | COTRICITY HEALTH GROUP OF FLORIDA, P.A. |
| Entity Type | Organization |
| Authorized Contact | ELIZABETH NELSON Legal Counsel 843-540-7108 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 103T00000X Psychologist |
| Enumeration Date | 2022-08-25 |
| Last Update Date | 2023-12-07 |