| NPI | 1548741705 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE MILNE Psychologist/Manager 904-270-4040 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY9283) |
| Enumeration Date | 2018-08-27 |
| Last Update Date | 2022-01-24 |