| NPI | 1285672063 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MASHARIA ANN CLARK Owner 727-687-7076 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL 3023802) |
| Enumeration Date | 2006-06-03 |
| Last Update Date | 2020-08-22 |