| NPI | 1558761841 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA LYNN HAINSWORTH Ra 904-729-2719 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH10676) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL MH10995) |
| Enumeration Date | 2014-08-25 |
| Last Update Date | 2014-08-25 |