| NPI | 1720347552 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY G DAVENPORT Psychotherapist 941-366-3134 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: FL 1503) |
| Enumeration Date | 2012-05-14 |
| Last Update Date | 2012-05-14 |