| NPI | 1902207897 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RACHEL CANNON GHULAMANI Owner 352-388-4121 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL 11918) |
| Enumeration Date | 2014-09-10 |
| Last Update Date | 2014-09-10 |