| NPI | 1245340181 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUDY ANNETTE ANDERSON Director 239-433-1211 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: SW2152) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MH1415) |
| 101YM0800X Counselor, Mental Health (Licence: MH1737) | |
| 101YM0800X Counselor, Mental Health (Licence: MT1159) | |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2020-08-22 |