| NPI | 1427263490 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | J. LISA WELLS Psychologist 407-273-5010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: FL Py4446) |
| Enumeration Date | 2007-05-13 |
| Last Update Date | 2020-08-22 |