| NPI | 1316499007 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BEVERLY JACKSON Licensed Mental Health Counselor 727-201-5460 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH8038) |
| Enumeration Date | 2016-10-27 |
| Last Update Date | 2016-10-27 |