| NPI | 1093209751 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JILL ANNE CANTRELL Licensed Mental Health Counselor 813-505-3956 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: FL MH9928) |
| Enumeration Date | 2018-06-18 |
| Last Update Date | 2019-12-12 |