| NPI | 1639576572 | 
|---|---|
| Doing Business As | J. PHYLLIS BRANNEN, LCSW, CAP | 
| Entity Type | Organization | 
| Authorized Contact | J. PHYLLIS BRANNEN Owner/Operator 813-482-2507  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: FL 1805AD627401)  | 
| Enumeration Date | 2014-11-20 | 
| Last Update Date | 2014-11-20 |