| NPI | 1417774449 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY LEEANN KILGORE Therapist 407-452-7592 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2024-09-23 |
| Last Update Date | 2024-09-23 |