| 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 |