| NPI | 1619264710 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VALERIE DEVILLE Owner/Operator 904-540-2840 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH8104) |
| Enumeration Date | 2011-07-09 |
| Last Update Date | 2011-07-09 |