| NPI | 1063920619 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLIE ELIZABETH VAZQUEZ Professional Counselor 904-750-1229 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CO LPC.0013572) |
| Enumeration Date | 2018-01-17 |
| Last Update Date | 2024-09-04 |