| NPI | 1477172971 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE EVANS Authorized Representative 813-527-8976 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2020-04-14 |
| Last Update Date | 2022-03-24 |