| NPI | 1679117618 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANCHETTA SUTTON Owner 904-866-6961 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2019-11-02 |
| Last Update Date | 2019-11-02 |