| NPI | 1588177711 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NANCY LOGAN DETWEILER Owner 352-338-1321 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: FL SW859) |
| Enumeration Date | 2017-11-09 |
| Last Update Date | 2017-11-09 |