NPI | 1235502113 |
---|---|
Entity Type | Organization |
Authorized Contact | TIMOTHY BYRD Psychiatrist 352-629-4350 |
Organization Subpart ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH1421) |
Additional Taxonomies | 103TS0200X Psychologist, School (Licence: FL SS81) |
Enumeration Date | 2015-11-02 |
Last Update Date | 2015-11-02 |