| NPI | 1922473339 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACY HUTCHINSON Licensed Mental Health Counselor 239-931-4444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL 13596) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NY 0004240) |
| Enumeration Date | 2015-12-10 |
| Last Update Date | 2015-12-10 |