| NPI | 1326101528 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARLENE B ANTONIO Managing Member 407-475-1025 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: FL PY4189) |
| Enumeration Date | 2006-12-18 |
| Last Update Date | 2007-08-08 |