| NPI | 1972082121 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAE NICOLE LUSTER Counselor/Owner 850-628-1956 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH13989) |
| Enumeration Date | 2018-08-08 |
| Last Update Date | 2018-08-08 |