| NPI | 1609276252 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRITTANY GREENE Administrative Assistant 850-226-7419 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH 5054) |
| Enumeration Date | 2014-09-02 |
| Last Update Date | 2014-09-02 |