| NPI | 1134629272 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EVERETTE COFFMAN Owner 352-988-5999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: FL 2324) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| Enumeration Date | 2018-02-15 |
| Last Update Date | 2020-09-17 |