| NPI | 1295079416 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LETICIA FREELAND GROVE Counselor 850-291-1344 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: FL MH9752) |
| Enumeration Date | 2012-11-15 |
| Last Update Date | 2016-02-04 |