| NPI | 1144582024 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA BROWN BULLA Licensed Counselor 727-328-4672 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: FL SW 10862) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2012-06-15 |
| Last Update Date | 2022-02-17 |