| NPI | 1619902103 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JODY E. TALBOTT Owner President 239-592-1771 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: FL PY 7020) |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2011-05-19 |