| NPI | 1356926695 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELE RONSISVALLE Chief Operations Officer 321-259-1662 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2021-03-17 |
| Last Update Date | 2025-07-09 |