| NPI | 1356392880 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE ROBINSON Credentialing Contact 239-791-6363 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 133V00000X Dietitian, Registered |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2021-05-21 |