| NPI | 1194069864 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLIE CHAPMAN Counselor 863-634-7226 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH9063) |
| Enumeration Date | 2012-11-19 |
| Last Update Date | 2012-11-19 |