| NPI | 1407383102 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDRIEAH JOHNSON Owner 904-536-5520 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH 14518) |
| Enumeration Date | 2017-05-12 |
| Last Update Date | 2017-05-12 |