| NPI | 1265843734 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VERLON C BRICKEY Owner 904-502-6352 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH5088) |
| Enumeration Date | 2014-05-18 |
| Last Update Date | 2014-05-18 |