NPI | 1427388834 |
---|---|
Entity Type | Organization |
Authorized Contact | KENNETH AMES Operations Manager 904-733-0777 |
Organization Subpart ? | No |
Primary Taxonomy | 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: FL SW8820) |
Enumeration Date | 2010-01-07 |
Last Update Date | 2010-01-07 |