NPI | 1396257630 |
---|---|
Entity Type | Organization |
Authorized Contact | LORI OSACHY Owner 904-737-3232 |
Organization Subpart ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: FL SW5916) |
Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: FL ND4743) |
Enumeration Date | 2017-10-26 |
Last Update Date | 2017-10-26 |