| NPI | 1932648961 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN JANE ALLEN Member Manager 813-373-0315 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH11850) |
| Enumeration Date | 2017-02-23 |
| Last Update Date | 2024-05-24 |