| NPI | 1043785926 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CYNTHIA LEIGH WILSON Licensed Clinical Psychologist 850-541-8520 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2018-10-08 |
| Last Update Date | 2018-10-08 |