| NPI | 1861925737 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE RODRIGUEZ Owner 772-579-6443 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH14487) |
| Enumeration Date | 2017-04-07 |
| Last Update Date | 2017-04-07 |