| NPI | 1528317401 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GILBERT JAMES RIORDAN Owner 863-382-8778 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: FL MT 0201) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: FL MH0432) |
| 251S00000X Community/Behavioral Health (Licence: FL CAP 1158) | |
| Enumeration Date | 2012-09-06 |
| Last Update Date | 2012-09-06 |