| NPI | 1346578457 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE-ANNE DIEHL Sole Member/Owner/Provider 813-957-2765 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL 8005) |
| Enumeration Date | 2009-12-01 |
| Last Update Date | 2020-06-04 |