| NPI | 1245521418 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LOUIS GONZARA DESONIER Owner Of Pa 850-444-7054 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY3062) |
| Enumeration Date | 2011-04-22 |
| Last Update Date | 2011-05-25 |