| NPI | 1255367918 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEISA DIANNE LUDLAM President 850-484-9026 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: FL PY0004705) |
| Enumeration Date | 2006-06-24 |
| Last Update Date | 2020-08-22 |