| NPI | 1578921631 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GWENDOLYN ALLEN Owner 904-236-1599 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH12222) |
| Enumeration Date | 2016-02-04 |
| Last Update Date | 2016-02-04 |