| NPI | 1427407238 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD KENNETH WILLENS Owner 407-629-4356 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent |
| Enumeration Date | 2016-06-13 |
| Last Update Date | 2016-06-13 |