| NPI | 1871134627 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIANNA KELLY JAWORSKI Owner 941-962-9661 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 251S00000X |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| Enumeration Date | 2019-10-02 |
| Last Update Date | 2022-10-28 |