| NPI | 1407030018 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY ANN CLARK Owner/President 941-746-8822 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY0004772) |
| Enumeration Date | 2007-12-19 |
| Last Update Date | 2008-04-11 |