| NPI | 1184806838 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK BENJAMIN MEYERS Owner 239-213-0051 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY7046) |
| Enumeration Date | 2007-12-04 |
| Last Update Date | 2021-03-29 |