| NPI | 1326394784 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW HOWARD GLASS Member 239-839-5904 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: FL SW 10707) |
| Enumeration Date | 2012-08-03 |
| Last Update Date | 2014-06-09 |