| NPI | 1740739226 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFANIE MONIQUE TRUDEAU Counselor 321-720-3444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH13469) |
| Enumeration Date | 2016-09-26 |
| Last Update Date | 2025-03-05 |