| NPI | 1619251287 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH JAMES COCHRANE Manager/Owner 352-406-5937 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY8381) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY 009300) |
| Enumeration Date | 2011-09-30 |
| Last Update Date | 2011-09-30 |