| NPI | 1801146360 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADELMA R REYES Owner/ Agent 813-416-6841 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH9542) |
| Enumeration Date | 2012-09-12 |
| Last Update Date | 2012-09-12 |