| NPI | 1093685166 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NELLA GLORIA CICIULLA ALBRECHT CEO 321-419-4947 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 103T00000X Psychologist |
| 103TC1900X Psychologist, Counseling | |
| 207Q00000X Family Medicine | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| 2084S0010X Psychiatry & Neurology, Sports Medicine | |
| 364SP0808X Clinical Nurse Specialist, Psych/Mental Health | |
| 101Y00000X Counselor | |
| 101YP2500X Counselor, Professional | |
| Enumeration Date | 2025-11-05 |
| Last Update Date | 2025-11-05 |