| NPI | 1487054904 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA BAILEY Medical Director 813-720-7411 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 103T00000X Psychologist |
| Enumeration Date | 2014-09-03 |
| Last Update Date | 2024-06-27 |