| NPI | 1770662033 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDRA KAYE FAUST Presdient 772-463-4190 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL LMHC 1474) |
| Enumeration Date | 2006-11-06 |
| Last Update Date | 2020-08-22 |