| NPI | 1134613334 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTEN DAVIS-JOHN Operating Manager 813-892-4082 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: FL PY5228) |
| Enumeration Date | 2018-06-20 |
| Last Update Date | 2018-06-20 |