| NPI | 1639423437 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUZANNE M ALLIE President 813-425-2569 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: FL PY7160) |
| Enumeration Date | 2012-10-31 |
| Last Update Date | 2014-10-22 |