| NPI | 1598275869 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIRANDA FAULKNER-SMITH Officer 813-440-2741 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: FL MH13166) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL MH13166) |
| 101YP2500X Counselor, Professional (Licence: VA 0701005890) | |
| Enumeration Date | 2017-10-02 |
| Last Update Date | 2018-03-17 |