| NPI | 1336495332 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACEE N MOORE Licensed Psychologist 813-714-7999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 103T00000X Psychologist (Licence: FL PY8549) |
| 103TA0700X Psychologist, Adult Development & Aging (Licence: FL PY8549) | |
| Enumeration Date | 2012-07-27 |
| Last Update Date | 2020-05-01 |