| NPI | 1104178607 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA ANNE DEEB Owner 727-808-4818 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: FL SW 8591) |
| Enumeration Date | 2012-10-08 |
| Last Update Date | 2014-06-26 |