| NPI | 1629447560 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KYLE JEFFREY DAY Licensed Clinical Social Worker 813-224-0355 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: FL SW13126) |
| Enumeration Date | 2015-09-22 |
| Last Update Date | 2016-03-23 |