| NPI | 1578926978 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEIGHANN WONG Licensed Psychologist 239-599-5656 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY8727) |
| Enumeration Date | 2016-04-01 |
| Last Update Date | 2020-12-11 |