| NPI | 1669010831 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBORAH BOYNTON Owner 863-937-3943 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YM0800X Counselor, Mental Health | |
| 101YP2500X Counselor, Professional | |
| 102L00000X Psychoanalyst | |
| 103T00000X Psychologist | |
| Enumeration Date | 2019-12-18 |
| Last Update Date | 2019-12-18 |