| NPI | 1396161121 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENISE ROSE MARIE EUBANKS Office Manager 407-647-1781 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: FL MH3392) |
| Enumeration Date | 2014-03-18 |
| Last Update Date | 2014-03-18 |