| NPI | 1225584394 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOMINIQUE MATHURIN Chief Operating Officer 407-403-8145 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 103TP2701X Psychologist, Group Psychotherapy | |
| Enumeration Date | 2016-08-29 |
| Last Update Date | 2016-08-29 |