| NPI | 1790194843 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENEE NICOLE TREVIRANUS VP Licensed Clinical Social Worker 407-216-9032 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: FL SW11257) |
| Enumeration Date | 2014-08-03 |
| Last Update Date | 2015-11-07 |