| NPI | 1710464003 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LESLIE J WONDRA Owner 954-787-9869 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WY LCSW-1003) |
| Enumeration Date | 2018-07-19 |
| Last Update Date | 2021-04-15 |