| NPI | 1942952213 |
|---|---|
| Doing Business As | MANGROVE THERAPY GROUP |
| Entity Type | Organization |
| Authorized Contact | BRIAN GONG Owner/Practitioner 561-404-0165 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2022-01-19 |
| Last Update Date | 2022-01-19 |