| NPI | 1093122483 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATALIE SUE WEST SOUTHWARD Director And Head Counselor 813-280-2474 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: FL IMH 7823) |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2014-07-17 |
| Last Update Date | 2021-01-21 |