| NPI | 1265072532 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE DESROCHERS Owner 850-449-0589 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 1041C0700X Social Worker Clinical |
| Enumeration Date | 2020-01-14 |
| Last Update Date | 2022-11-07 |