| NPI | 1568593135 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENDA CRAWFORD-CLARK CEO 813-504-0360 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL LMHC 5109) |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2012-03-01 |