| NPI | 1548439409 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDRA MARIE BALLESTER Licensed Psychologist/ Manager 863-424-0194 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY 7428) |
| Enumeration Date | 2008-02-25 |
| Last Update Date | 2015-03-26 |