| NPI | 1063023562 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMARA SUE GILARSKI Psychotherapist, Play Therapist/Sup 772-285-7245 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2020-08-10 |
| Last Update Date | 2020-08-10 |