| NPI | 1184913105 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBRA A WEAVER President 850-942-5585 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY4836) |
| Enumeration Date | 2011-03-30 |
| Last Update Date | 2011-03-30 |