| NPI | 1285977520 |
|---|---|
| Former Legal Business Name | AMY DATLA |
| Entity Type | Organization |
| Authorized Contact | AMY LANIER DATLA Owner 352-262-2163 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH 8831) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: FL MT 2809) |
| Enumeration Date | 2013-04-05 |
| Last Update Date | 2016-10-31 |