| NPI | 1285987453 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA REIDSEMA President 941-822-5620 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH12785) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: FL MH12785) |
| 101YP2500X Counselor, Professional (Licence: FL PY5867) | |
| 103TC0700X Psychologist, Clinical (Licence: FL PY5867) | |
| Enumeration Date | 2012-10-24 |
| Last Update Date | 2014-10-13 |