| NPI | 1497151369 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILSON GIOVANNI VILLANUEVA Clinical Director 407-930-4711 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH12912) |
| Enumeration Date | 2014-11-05 |
| Last Update Date | 2022-03-03 |