| NPI | 1134282015 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KHALIL A SAKALLA Owner Provider 352-281-8526 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY 7142) |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2020-08-22 |