| NPI | 1053709980 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAUREN K HARDISON Billing Manager 877-842-5246 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH 10307) |
| Enumeration Date | 2014-12-30 |
| Last Update Date | 2014-12-30 |