| NPI | 1649621962 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA K. COUTAIN Owner 954-851-4640 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH 14023) |
| Enumeration Date | 2016-06-28 |
| Last Update Date | 2016-06-28 |