| NPI | 1639615537 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ISLAINE ST.VIL Licensed Clinical Social Worker 813-495-6702 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: FL SW 13121) |
| Enumeration Date | 2017-01-16 |
| Last Update Date | 2017-01-16 |