| NPI | 1063951309 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE WENTWORTH Owner 813-391-3495 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: FL MT3180) |
| Enumeration Date | 2017-02-20 |
| Last Update Date | 2017-02-20 |