| NPI | 1740762509 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HOLLEY KELLY FRAZER Business Office Manager 407-221-8671 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NC C005320) |
| Enumeration Date | 2018-08-29 |
| Last Update Date | 2018-08-29 |