| NPI | 1326455783 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TYSON H KUCH Therapist 321-872-8627 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL IMH6666) |
| Enumeration Date | 2014-07-17 |
| Last Update Date | 2014-07-17 |