| NPI | 1356878128 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMANTHA LYNN CHARBONNEAU Marriage And Family Therapist 407-466-3467 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: FL MT2058) |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2017-05-11 |