| NPI | 1093753147 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEY FOGARTY LASS Licensed Psychologist 813-789-3709 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY7188) |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2020-08-22 |