| NPI | 1508133158 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID EDWARD SOMMERFELD Manager 772-494-2700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YM0800X Counselor, Mental Health | |
| 101YP2500X Counselor, Professional | |
| 102L00000X Psychoanalyst | |
| 103T00000X Psychologist | |
| 103TA0700X Psychologist, Adult Development & Aging | |
| 103TB0200X Psychologist, Cognitive & Behavioral | |
| 103TC1900X Psychologist, Counseling | |
| 103TH0100X Psychologist, Health Service | |
| 103TP0016X Psychologist, Prescribing (Medical) | |
| 103TP0814X Psychologist, Psychoanalysis | |
| 103TP2701X Psychologist, Group Psychotherapy | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry | |
| Enumeration Date | 2011-11-28 |
| Last Update Date | 2011-11-28 |