| NPI | 1376142463 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YASMIN LUGO MORALES Program Director 321-325-0699 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities | |
| 103TP0814X Psychologist, Psychoanalysis | |
| 103TP2701X Psychologist, Group Psychotherapy | |
| 103T00000X Psychologist | |
| 103TA0700X Psychologist, Adult Development & Aging | |
| 103TB0200X Psychologist, Cognitive & Behavioral | |
| 103TC1900X Psychologist, Counseling | |
| Enumeration Date | 2020-10-20 |
| Last Update Date | 2020-10-20 |