| NPI | 1427787217 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACEY CLAIRE MCCORMACK Owner 850-328-2707 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2022-06-07 |
| Last Update Date | 2022-06-22 |