| NPI | 1629596739 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT IMPOLA Executive Director 305-988-5251 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY8007) |
| Enumeration Date | 2017-09-08 |
| Last Update Date | 2017-09-08 |