| NPI | 1902828809 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUANITA LARRY RILEY Therapist 407-291-1680 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH4756) |
| Enumeration Date | 2006-07-23 |
| Last Update Date | 2007-12-21 |