| NPI | 1063647782 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER BRUCE-MCGOLDRICK Psychologist 813-382-1459 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY7716) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: FL 1-01-0483) |
| Enumeration Date | 2009-05-26 |
| Last Update Date | 2009-05-26 |