| NPI | 1326687070 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA JACKSON Owner 850-296-6811 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 104100000X Social Worker |
| 1041S0200X Social Worker, School | |
| Enumeration Date | 2019-12-29 |
| Last Update Date | 2019-12-29 |