| NPI | 1639496110 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEORGE RONNIE GRUBBS President 813-789-0552 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY7985) |
| Enumeration Date | 2010-04-23 |
| Last Update Date | 2014-06-04 |