| NPI | 1457458077 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREA CLARK President 239-334-8144 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084S0012X Psychiatry & Neurology, Sleep Medicine |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry |
| 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology | |
| Enumeration Date | 2006-09-17 |
| Last Update Date | 2011-06-02 |