| NPI | 1104233394 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ISABEL TANENBAUM Owner 904-292-2407 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH 5265) |
| Enumeration Date | 2014-07-19 |
| Last Update Date | 2014-07-19 |