| NPI | 1346905916 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID ALLAN SPELLMAN Owner 386-624-2177 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2021-11-08 |
| Last Update Date | 2021-11-08 |