| NPI | 1265245039 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEXIS BOLLING Licensed Clinical Social Worker 352-792-4153 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2025-01-27 |
| Last Update Date | 2025-01-27 |