| NPI | 1972054765 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TOLONDA NICOLE TATE Mental Health Practitioner 850-345-0405 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH 11832) |
| Enumeration Date | 2016-10-17 |
| Last Update Date | 2016-10-17 |