| NPI | 1447568316 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ZACHARY WILLIAM DODSON Co Owner 321-945-9915 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL IMH8451) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL IMH8423) |
| Enumeration Date | 2010-09-14 |
| Last Update Date | 2010-09-14 |