| NPI | 1073900932 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSE SPARKS Professional Counselor 407-325-5521 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL mh9947) |
| Enumeration Date | 2015-04-17 |
| Last Update Date | 2015-04-17 |