| NPI | 1114348117 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALLISON BONILLA Psychotherapist 386-774-1330 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: FL sw4260) |
| Enumeration Date | 2013-12-18 |
| Last Update Date | 2013-12-18 |