| NPI | 1245775931 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY LYNN SOLDERICH Owner/Psychologist 772-925-1121 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: FL PY 9632) |
| Enumeration Date | 2017-01-04 |
| Last Update Date | 2022-11-21 |