| NPI | 1265434534 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENDA MASON Office Manager 352-530-2170 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: FL PY6497) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: FL PY6497) |
| Enumeration Date | 2005-06-01 |
| Last Update Date | 2021-03-29 |