| NPI | 1407502206 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELITA COGBURN Mental Health Therapist Owner 407-900-3518 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Enumeration Date | 2022-03-01 |
| Last Update Date | 2022-03-01 |