| NPI | 1649656786 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CYNTHIA A PARKES Owner 386-846-7525 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: FL PMH1158) |
| Enumeration Date | 2015-07-30 |
| Last Update Date | 2015-07-30 |