| NPI | 1366989097 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS ANTONEK Psychologist 813-994-5595 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: ZZ PY6278) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: ZZ MH10508) |
| Enumeration Date | 2017-01-19 |
| Last Update Date | 2017-01-19 |