| NPI | 1669260998 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFANY TERRY Owner 850-495-9217 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2025-04-28 |
| Last Update Date | 2025-10-22 |