| NPI | 1366739419 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROL WATLER Owner 407-951-4370 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL MH9938) |
| Enumeration Date | 2011-07-08 |
| Last Update Date | 2011-07-08 |