| NPI | 1801263108 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KARLY S SHREDERS Lmhc 904-200-0604 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH 10130) |
| Enumeration Date | 2015-08-21 |
| Last Update Date | 2015-08-21 |