| NPI | 1245599661 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRUCE L. STAFFORD Lilcensed Clinical Socail Worker 407-648-9118 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: FL sw1618) |
| Enumeration Date | 2012-05-04 |
| Last Update Date | 2012-05-04 |