| NPI | 1073055232 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE S DUTTON Clinical Psychologist 850-832-6724 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: FL PY8095) |
| Enumeration Date | 2016-11-04 |
| Last Update Date | 2018-06-20 |