| NPI | 1801954094 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | ALLEN DROZD Director 904-687-1592  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NY 000057-1)  | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL MH0003697)  | 
| 101YM0800X Counselor, Mental Health (Licence: FL MH5527)  | |
| 103TC0700X Psychologist, Clinical (Licence: FL PY6700)  | |
| Enumeration Date | 2006-12-04 | 
| Last Update Date | 2025-09-11 |