| NPI | 1639324817 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELISABETH PESCE Secretary 904-605-4986 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IN 34005107A) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IN 39001690A) |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2008-12-01 |
| Last Update Date | 2023-09-22 |