| NPI | 1780116822 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELCEY KILLINGSWORTH Owner/Therapist 850-602-2411 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: FL MH 10486) |
| Enumeration Date | 2017-03-29 |
| Last Update Date | 2017-03-29 |