| NPI | 1437519352 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL CONNOLLY Licensed Clinician 904-234-7803 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: FL MH 4717) |
| Enumeration Date | 2016-03-04 |
| Last Update Date | 2016-03-04 |