| NPI | 1548573256 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NYDIA CONRAD Licensed Psychologist 813-480-6427 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: FL 8091) |
| Enumeration Date | 2010-07-22 |
| Last Update Date | 2010-12-02 |