| NPI | 1497290738 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA ROBERTSON CARR Owner 239-895-8146 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH11294) |
| Enumeration Date | 2016-12-22 |
| Last Update Date | 2016-12-22 |