| 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 |