| NPI | 1265911382 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH DUMVILLE Owner/Provider 863-606-6001 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH6514) |
| Enumeration Date | 2018-08-09 |
| Last Update Date | 2018-08-09 |