| NPI | 1164542270 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE ANN SUMMERS Officer 904-268-9178 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: FL MT2128) |
| Enumeration Date | 2007-03-30 |
| Last Update Date | 2008-03-11 |