| NPI | 1073646147 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAWNA MARIE FRESHWATER President 305-632-9902 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: FL py6446) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: FL PY6446) |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2020-08-22 |