| NPI | 1245593672 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ATALIA FOGEL-BOBO Owner 813-400-0419 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MA8896) |
| Enumeration Date | 2012-06-20 |
| Last Update Date | 2012-06-20 |