| NPI | 1841664836 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GINA TILLMAN Adult & Family Therapist 941-313-7040 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: FL SW12757) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: FL SW12758) |
| Enumeration Date | 2015-11-14 |
| Last Update Date | 2015-11-14 |