| NPI | 1407210800 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN C MCCLAIN Owner/Therapist 904-525-0268 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: FL SW12771) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: FL SW12771) |
| Enumeration Date | 2016-04-12 |
| Last Update Date | 2016-04-12 |