| NPI | 1558048405 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER MATILLA Licensed Mental Health Counselor/Qu 904-773-4665 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| Enumeration Date | 2023-07-03 |
| Last Update Date | 2023-07-03 |