| NPI | 1609211044 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUDITH HORVATH Manager 863-658-0151 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: FL PY8325) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: FL PY8325) |
| Enumeration Date | 2013-04-29 |
| Last Update Date | 2013-04-30 |