| NPI | 1124556840 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACQUELINE ANNE GIBB President 813-360-3569 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL 12739) |
| Enumeration Date | 2017-05-24 |
| Last Update Date | 2018-06-16 |