| NPI | 1841803210 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTOINETTE WATSON Nurse Practitioner/Owner 813-714-7397 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2020-08-26 |
| Last Update Date | 2020-08-26 |