| NPI | 1235504978 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CONNIE E CLARK CEO, Psychotherapist 904-743-2327 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL IMH11902) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: FL ADC-010509-2015) |
| Enumeration Date | 2015-12-07 |
| Last Update Date | 2015-12-07 |