| NPI | 1083258370 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARRIE LYNN JOHNSON Owner/Therapist 239-312-5352 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TP2701X Psychologist, Group Psychotherapy |
| Enumeration Date | 2019-10-30 |
| Last Update Date | 2020-03-31 |