| NPI | 1376908988 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAHALLA V LENZI Psychologist 772-220-3783 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: FL PY3921) |
| Enumeration Date | 2015-12-24 |
| Last Update Date | 2015-12-24 |