| NPI | 1639714793 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOMINIQUE C LEVEILLE Lmft 305-922-3436 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist |
| Enumeration Date | 2019-11-13 |
| Last Update Date | 2022-02-15 |