| NPI | 1548856933 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARITA BRYANT Owner 904-648-6200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 101YP2500X Counselor, Professional | |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2020-12-19 |
| Last Update Date | 2020-12-19 |