| NPI | 1114396165 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BERNICE VAZQUEZ GARAY Owner 321-430-7017 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY9271) |
| Enumeration Date | 2015-09-21 |
| Last Update Date | 2015-09-21 |