| NPI | 1275163370 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEANNIE MITCHELL Licensed Mental Health Counselor 904-264-6977 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2020-01-17 |
| Last Update Date | 2020-01-17 |