| NPI | 1639781255 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRITTANY WADE Licensed Clinical Psychologist 941-416-1743 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent |
| Enumeration Date | 2020-08-17 |
| Last Update Date | 2020-08-17 |