| NPI | 1457865586 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CYNTHIA LEE CHAUSSE Director/Clinician 941-235-7215 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH3566) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: FL MH3566) |
| 101YS0200X Counselor, School (Licence: FL MH3566) | |
| Enumeration Date | 2017-11-28 |
| Last Update Date | 2017-11-28 |