| NPI | 1457853681 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIANA VANDIVIER Lcsw/Owner 239-289-8606 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: FL SW12150) |
| Enumeration Date | 2018-03-04 |
| Last Update Date | 2021-09-28 |