| NPI | 1710445044 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAKEENA DENISE BRANTLEY Social Worker/Counselor 407-603-9710 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Enumeration Date | 2019-03-05 |
| Last Update Date | 2019-03-05 |