| NPI | 1013729599 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LIBANESSA PICHARDO COO 850-687-5990 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry |
| Additional Taxonomies | 103TC1900X Psychologist Counseling |
| Enumeration Date | 2025-01-22 |
| Last Update Date | 2025-01-22 |