| NPI | 1508368192 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL PAULSON Co Owner 407-756-2084 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TB0200X Psychologist Cognitive & Behavioral (Licence: FL PY9901) |
| Enumeration Date | 2018-02-28 |
| Last Update Date | 2020-10-05 |