| NPI | 1578990784 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA LYNN HAINSWORTH Mental Health Counselor/Owner 386-965-3577 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH10995) |
| Enumeration Date | 2013-10-02 |
| Last Update Date | 2013-10-02 |