| NPI | 1457631525 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT B SILVER Director 239-936-1336 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist |
| 103TC0700X Psychologist, Clinical | |
| 103TC2200X Psychologist, Clinical Child & Adolescent | |
| 103TF0000X Psychologist, Family | |
| 103TF0200X Psychologist, Forensic | |
| 103TS0200X Psychologist, School | |
| Enumeration Date | 2011-08-22 |
| Last Update Date | 2011-08-22 |