| NPI | 1326289513 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON COOK Sole Menber 727-255-3736 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL py 7486) |
| Enumeration Date | 2009-03-17 |
| Last Update Date | 2009-07-16 |