| NPI | 1528757176 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANTELL WHITAKER Owner/Employee 904-576-6868 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 101YP1600X Counselor Pastoral |
| 101YS0200X Counselor School | |
| Enumeration Date | 2023-05-01 |
| Last Update Date | 2023-05-01 |