| NPI | 1821471434 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA MANLEY Counselor 1941-264-8742 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH12808) |
| Enumeration Date | 2015-06-30 |
| Last Update Date | 2015-06-30 |