| NPI | 1487989034 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNNETTE D MACKENZIE Owner/Authorized Official 727-412-8003 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: FL PY7984) |
| Enumeration Date | 2009-10-14 |
| Last Update Date | 2010-12-03 |