| NPI | 1083971923 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTEN PATTERSON Manager 786-258-8499 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL mh4989) |
| Additional Taxonomies | 174400000X Specialist (Licence: FL mh4989) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL 801537) | |
| Enumeration Date | 2012-04-17 |
| Last Update Date | 2024-03-09 |