| NPI | 1386124816 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARL G BUTLER Administrator 813-270-3343 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: FL SW12938) |
| Enumeration Date | 2018-08-15 |
| Last Update Date | 2018-08-15 |