| NPI | 1336314707 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM HARRY PETTIBON Clinical Psychologist/Owner 941-366-1693 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: FL PY6096) |
| Enumeration Date | 2008-04-28 |
| Last Update Date | 2008-04-28 |