| NPI | 1578504296 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELISABETH PESCE Secretary 904-605-4986 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MD LC1673) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: MD lc2429) |
| 101Y00000X Counselor (Licence: MD lc2348) | |
| 101YM0800X Counselor, Mental Health (Licence: MD LC1232) | |
| 103TC0700X Psychologist, Clinical (Licence: MD 1003) | |
| 103TC0700X Psychologist, Clinical (Licence: MD 2350) | |
| 103TC0700X Psychologist, Clinical (Licence: MD 3296) | |
| 103TC0700X Psychologist, Clinical (Licence: MD 03544) | |
| 103TC0700X Psychologist, Clinical (Licence: MD 04092) | |
| 1041C0700X Social Worker, Clinical (Licence: MD 12435) | |
| 1041C0700X Social Worker, Clinical (Licence: MD 10602) | |
| 1041C0700X Social Worker, Clinical (Licence: MD 09110) | |
| 1041C0700X Social Worker, Clinical (Licence: MD 07183) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MD D0060930) | |
| Enumeration Date | 2006-06-10 |
| Last Update Date | 2023-02-07 |