| NPI | 1982979662 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THERESA M HENDERSON President 813-716-0585 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: FL SW2072) |
| Enumeration Date | 2012-03-14 |
| Last Update Date | 2012-03-28 |