| NPI | 1750862017 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN WALLACE STONE Authorized Manager 727-310-5520 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: FL SW14906) |
| Enumeration Date | 2018-08-24 |
| Last Update Date | 2018-08-24 |