| NPI | 1215783758 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PANYA MITCHELL Lmft 813-527-5775 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2024-04-25 |
| Last Update Date | 2024-04-25 |