| NPI | 1740627959 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACY A LOUK Managing Member 941-925-8570 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH9651) |
| Enumeration Date | 2013-05-29 |
| Last Update Date | 2013-05-29 |