| NPI | 1164747739 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN M PAGE President 850-682-1234 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH3244) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MH3313) |
| 101YM0800X Counselor, Mental Health (Licence: FL MH5026) | |
| 103T00000X Psychologist (Licence: FL PY7250) | |
| Enumeration Date | 2010-04-07 |
| Last Update Date | 2024-05-21 |