| NPI | 1578025490 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | BRITTANY LEDFORD Therapist 904-515-5090  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health | 
| Enumeration Date | 2019-04-01 | 
| Last Update Date | 2019-04-01 |