| NPI | 1336800754 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CELENE A FYFFE Owner 850-270-3307 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2022-01-07 |
| Last Update Date | 2022-01-07 |