| NPI | 1104473503 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD RIOS Secretary 786-379-4466 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist |
| 103TC1900X Psychologist, Counseling | |
| Enumeration Date | 2019-08-20 |
| Last Update Date | 2019-08-20 |