| NPI | 1215345327 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEITH DALY Owner 321-209-3259 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YM0800X Counselor, Mental Health | |
| 103T00000X Psychologist | |
| 103TC0700X Psychologist, Clinical | |
| 103TC2200X Psychologist, Clinical Child & Adolescent | |
| 103TF0000X Psychologist, Family | |
| 103TP2701X Psychologist, Group Psychotherapy | |
| 104100000X Social Worker | |
| 1041C0700X Social Worker, Clinical | |
| 106H00000X Marriage & Family Therapist | |
| 102X00000X Poetry Therapist | |
| Enumeration Date | 2014-08-01 |
| Last Update Date | 2015-02-05 |