| NPI | 1598118242 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN G SCLAN Owner; President 904-639-6999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY6845) |
| Enumeration Date | 2016-07-18 |
| Last Update Date | 2016-07-18 |