| NPI | 1629480231 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BONNIE SLADE President 321-729-0870 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: FL PY002036) |
| Enumeration Date | 2014-05-30 |
| Last Update Date | 2014-05-30 |