| NPI | 1679019525 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA PAGAN Mental Health Therapist 352-339-5848 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL 11914) |
| Enumeration Date | 2017-01-17 |
| Last Update Date | 2017-01-17 |