| NPI | 1679000350 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEY P PENNEWILL Owner 850-501-1150 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: FL SW11608) |
| Enumeration Date | 2017-05-12 |
| Last Update Date | 2017-05-12 |