| NPI | 1073910931 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIGUEL MORENO COLON Owner 904-745-0067 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TB0200X Psychologist, Cognitive & Behavioral |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YM0800X Counselor, Mental Health | |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2014-11-20 |
| Last Update Date | 2017-02-27 |