| NPI | 1245941343 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OLATUNDE FATINIKUN Manager 813-445-5538 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry |
| Additional Taxonomies | 101YP2500X Counselor Professional |
| 1041C0700X Social Worker Clinical | |
| Enumeration Date | 2022-12-09 |
| Last Update Date | 2022-12-09 |