| NPI | 1467166215 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE E. MORRELL Clinician 941-404-9664 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2023-01-06 |
| Last Update Date | 2023-07-17 |