| NPI | 1669789319 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARTER TYRONE WIGGINS Partner 305-825-5698 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: FL SW4348) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: FL 80292) |
| Enumeration Date | 2010-09-01 |
| Last Update Date | 2010-09-01 |