| NPI | 1831969021 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIERA WOODARD Clinical Social Worker 386-316-4270 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2024-01-08 |
| Last Update Date | 2025-11-21 |