| NPI | 1215503313 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIELLE SANDY Sole Member 813-699-0886 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 1041C0700X Social Worker Clinical |
| Enumeration Date | 2021-05-29 |
| Last Update Date | 2022-03-15 |