| NPI | 1144695644 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANA MOUSSEAU Director 850-710-3702 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: FL sw11592) |
| Enumeration Date | 2015-12-09 |
| Last Update Date | 2015-12-09 |