| NPI | 1396225918 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARRELL WAYNE FENNELL President 813-557-7118 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH15956) |
| Enumeration Date | 2018-08-14 |
| Last Update Date | 2018-08-14 |