| NPI | 1982043840 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT MEDINA License Therapist 813-416-5458 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: FL MH9670) |
| Enumeration Date | 2013-06-24 |
| Last Update Date | 2013-06-24 |