| NPI | 1578021655 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHERINE BLAIRE POLLAK FELL Owner/Clinical Psychologist 813-603-8181 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC2200X Psychologist Clinical Child & Adolescent |
| Enumeration Date | 2019-03-07 |
| Last Update Date | 2019-03-07 |