| NPI | 1801063136 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL KELLOGG Counselor 407-891-9607 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH6448) |
| Enumeration Date | 2008-05-15 |
| Last Update Date | 2008-05-15 |