| NPI | 1710384813 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARRIE KYOKO LACAYO-BENTON President 904-201-9533 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: FL SW10201) |
| Enumeration Date | 2014-12-04 |
| Last Update Date | 2014-12-04 |