| NPI | 1073862892 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANA LANE Sole Proprietor 813-240-5769 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH 2860) |
| Enumeration Date | 2012-09-07 |
| Last Update Date | 2012-09-07 |