| NPI | 1427670959 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RACHEL MCKENNA Owner 727-999-2750 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry |
| 261QM0801X | |
| Enumeration Date | 2020-05-06 |
| Last Update Date | 2020-05-06 |