| NPI | 1649603259 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER ANDERSON ROGERS Mental Health Therapist 386-717-0982 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2013-08-19 |
| Last Update Date | 2013-08-19 |