| NPI | 1639472939 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTIE VIRGINIA COCHRAN Owner 941-792-0802 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: FL SW2098) |
| Enumeration Date | 2010-12-08 |
| Last Update Date | 2025-02-06 |