| NPI | 1851196794 |
|---|---|
| Doing Business As | XXX-XX-XXXX |
| Entity Type | Organization |
| Authorized Contact | MACKENZIE C TORRES Licensed Mental Health Counselor 321-368-0589 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2025-02-14 |
| Last Update Date | 2025-02-14 |