| NPI | 1114122215 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANETTE E EDWARDS Owner 904-448-1992 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: FL SOW2185) |
| Enumeration Date | 2007-06-19 |
| Last Update Date | 2019-01-09 |