| NPI | 1386040558 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIETHA DESTIN Owner 813-322-3262 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: FL IMT 1842) |
| Enumeration Date | 2014-11-14 |
| Last Update Date | 2014-11-14 |