| NPI | 1407661721 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAVELYN MILLARD Director 239-396-0181 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 103T00000X Psychologist |
| 235Z00000X Speech-Language Pathologist, | |
| 101Y00000X Counselor | |
| 225X00000X Occupational Therapist | |
| 103K00000X Behavior Analyst | |
| Enumeration Date | 2025-02-12 |
| Last Update Date | 2026-02-23 |