| NPI | 1407281413 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PASQUALE A CAPOZZOLI Owner 239-274-7792 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY8575) |
| Enumeration Date | 2013-09-09 |
| Last Update Date | 2015-08-10 |