| NPI | 1366968554 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA R GREAVES Owner, Psychotherapist 813-505-6867 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL SW14306) |
| Additional Taxonomies | 261QD1600X Clinic/Center, Developmental Disabilities (Licence: FL SW14306) |
| 261QM0850X Clinic/Center, Adult Mental Health (Licence: FL SW14306) | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: FL SW14306) | |
| Enumeration Date | 2017-08-18 |
| Last Update Date | 2022-07-21 |