| NPI | 1851173199 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREA CHANELLE MCPHATTER Practitioner 813-510-0572 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 101YP2500X Counselor Professional |
| Enumeration Date | 2023-10-20 |
| Last Update Date | 2023-10-20 |