| NPI | 1760850200 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER ANN DAHL Owner 904-651-2490 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH 6933) |
| Enumeration Date | 2015-09-14 |
| Last Update Date | 2015-09-14 |