| NPI | 1649657289 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE STORY President 904-234-0574 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: FL MT2208) |
| Additional Taxonomies | 103TC1900X Psychologist, Counseling (Licence: FL MH7433) |
| Enumeration Date | 2015-05-04 |
| Last Update Date | 2015-05-04 |