| NPI | 1396125514 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA MARIE BOLHOUSE Owner, Private Practice 850-443-8977 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: FL SW1872) |
| Enumeration Date | 2015-06-03 |
| Last Update Date | 2015-06-03 |