| NPI | 1477604809 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH JOHN SESTA President 813-293-9423 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: FL PY0005130) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: FL PY0005130) |
| 103TC0700X Psychologist, Clinical (Licence: FL PY0005130) | |
| 103TF0200X Psychologist, Forensic (Licence: FL PY0005130) | |
| 103TH0100X Psychologist, Health Service (Licence: FL PY0005130) | |
| Enumeration Date | 2007-01-14 |
| Last Update Date | 2020-08-22 |