| NPI | 1225075047 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KERRY M COLTER President 561-790-1191 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: FL PY4673) |
| 251S00000X | |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2020-02-26 |