NPI | 1104568039 |
---|---|
Entity Type | Organization |
Authorized Contact | WENDY GIBBS Lmft, Qualified Supervisor, Owner 352-900-3130 |
Organization Subpart ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health |
Additional Taxonomies | 106H00000X Marriage & Family Therapist |
Enumeration Date | 2022-04-11 |
Last Update Date | 2024-01-08 |