| NPI | 1285050930 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACLYN LEE LEWIS-CROSWELL Psychologist 813-679-6300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: FL PY7760) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: FL PY7852) |
| Enumeration Date | 2014-03-05 |
| Last Update Date | 2014-03-05 |