| NPI | 1235264326 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEORGE DEITCHMAN Director 904-568-8927 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: FL MT 1169) |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2020-08-22 |