| NPI | 1851773121 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYDIA KICKLITER Sole Member 727-643-5594 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NC 12763) |
| Enumeration Date | 2015-06-23 |
| Last Update Date | 2017-10-12 |