| NPI | 1033313903 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA SUNDVALL MERILSON Psychologist 386-423-0442 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: FL PY6889) |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: FL py6889) |
| Enumeration Date | 2007-06-13 |
| Last Update Date | 2008-08-29 |