| NPI | 1730618299 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SONJA VARNER-ALSTON Licensed Clinical Marriage & Family 850-499-6181 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X (Licence: MD LCM636) |
| Enumeration Date | 2017-06-08 |
| Last Update Date | 2017-06-08 |