| NPI | 1114163755 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE RENEE DAVIS Executive Director 305-933-5733 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY7520) |
| Enumeration Date | 2009-01-04 |
| Last Update Date | 2009-01-04 |