| NPI | 1306440482 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAENEQUA E BAKER Owner 813-842-0469 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YP2500X Counselor Professional | |
| Enumeration Date | 2020-11-30 |
| Last Update Date | 2020-11-30 |