| NPI | 1083157663 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTINE J LEWIS Owner/Provider 321-746-3043 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH11032) |
| Enumeration Date | 2016-11-30 |
| Last Update Date | 2016-11-30 |