| NPI | 1730676057 |
|---|---|
| Doing Business As | COASTAL COUNSELING PCB |
| Entity Type | Organization |
| Authorized Contact | TREGON FITCH Manager/Counselor 850-733-7720 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X (Licence: FL 11097) |
| Enumeration Date | 2018-04-23 |
| Last Update Date | 2018-04-23 |