| NPI | 1700978368 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LOUISE ANN AXELBERG Licensed Clinical Social Worker 904-399-0404 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: FL SW4315) |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2020-08-22 |