| NPI | 1538913082 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY WAGNER Owner 407-488-9043 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2024-04-12 |
| Last Update Date | 2024-04-12 |