| NPI | 1457914343 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YIARA S BLANCO Licensed Clinical Psychologist 813-701-2471 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Enumeration Date | 2019-04-17 |
| Last Update Date | 2019-04-17 |