| NPI | 1629323423 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GINGER M TALERICO Owner/Manager 941-567-6207 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH8857) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL MH9081) |
| Enumeration Date | 2012-07-17 |
| Last Update Date | 2012-07-17 |