| NPI | 1972878387 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC RAY LEEVER Licensed Mental Health Counselor 772-233-9982 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2012-03-19 |
| Last Update Date | 2012-03-19 |