| NPI | 1053678813 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALLISON P. VALEZ Owner 850-376-2682 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: FL 4141) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL 4865) |
| 106H00000X Marriage & Family Therapist (Licence: FL 2650) | |
| Enumeration Date | 2012-04-18 |
| Last Update Date | 2012-04-18 |