| NPI | 1942952213 |
|---|---|
| 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 |