| NPI | 1356208987 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE ELISE KISTLER Licensed Clinical Social Worker 850-255-4779 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2026-01-06 |
| Last Update Date | 2026-01-06 |