| NPI | 1679012439 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GWENDOLEN H DAVIS President 904-716-5619 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: FL SW7677) |
| Enumeration Date | 2017-02-13 |
| Last Update Date | 2017-02-13 |