| NPI | 1598929879 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD HARRY FULTON Owner 904-730-7575 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: FL MT1278) |
| Enumeration Date | 2008-07-15 |
| Last Update Date | 2008-07-15 |