| NPI | 1568757458 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROL HOOPER Owner/Operator 9045-010-2846 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: FL SW5803) |
| Enumeration Date | 2011-06-19 |
| Last Update Date | 2011-06-19 |