| NPI | 1801002431 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT SCOTT WALTON President 904-733-9669 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH2109) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL MH209) |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2020-08-22 |