| NPI | 1396161881 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY KELLY President/Owner 904-647-7567 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH8940) |
| Enumeration Date | 2014-03-09 |
| Last Update Date | 2014-03-09 |