| NPI | 1043684780 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACQUELINE ROLLER Psychologist 941-951-1919 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: FL PY7240) |
| Enumeration Date | 2015-11-18 |
| Last Update Date | 2015-11-18 |