| NPI | 1760997787 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER M BAGWELL Owner 954-465-6988 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: FL SW6366) |
| Enumeration Date | 2017-12-13 |
| Last Update Date | 2017-12-13 |