| NPI | 1700529369 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WENDY L BRADSHAW Owner 813-687-5858 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 101Y00000X Counselor | |
| Enumeration Date | 2022-04-20 |
| Last Update Date | 2022-04-20 |